IN FULL: The Hon Mark Butler MP's Address to the National Press Club

Mark Butler, Minister for Health and Aging, addressed the National Press Club, emphasizing the need to ensure the sustainability of the National Disability Insurance Scheme (NDIS). Butler highlighted the challenges of maintaining the scheme's growth rate, aiming to reduce it from 22% to a more sustainable 5-6% by focusing on market discipline and fraud prevention. He announced the "Thriving Kids" initiative to provide mainstream support for children with mild developmental delays, diverting them from the NDIS. Butler stressed collaboration with states and the disability community to uphold the scheme's integrity and social license.

• Mark Butler begins by acknowledging the traditional custodians of the land and paying respects to elders past, present, and emerging.
• Emphasizes the importance of the NDIS and his commitment to ensuring support for people with disabilities.

"Can I acknowledge at the outset of course that we come together on the lands of the Nanoal and Nambry people and pay my respects to their elders past, present and emerging."

• Acknowledging the traditional custodians sets a respectful tone and recognizes the history and culture of the land.

• Butler reflects on his early career in the care economy, witnessing the transformation from large institutions to more personalized care.
• Highlights the profound impact of the NDIS compared to past institutional care.

"Today I now have the privilege of talking, for example, with a young adult with a profound disability who is supported by the NDIS and comparing their position to the residents that I met 30 years ago or more. And the difference is beyond profound."

• The quote illustrates the significant progress made in disability care, emphasizing the transformative impact of the NDIS.

• The NDIS emerged from decades of advocacy by disability rights movements and was realized through bipartisan political support.
• It symbolizes democratic achievement when collaborative efforts are prioritized.

"The NDIS, of course, didn't drop out of the sky. It was the product of determined advocacy by disability advocates stretching back decades."

• This underscores the long-term advocacy efforts and the importance of political cooperation in achieving meaningful social reform.

• The NDIS is entering a critical phase of growth and sustainability challenges.
• Emphasizes the need to return to the scheme's original purpose and ensure fiscal sustainability.

"The NDIS has grown incredibly fast and well beyond projections. It's created new markets which have in turn impacted and sometimes distorted other parts of the health and social care ecosystem."

• The rapid growth and impact on other sectors highlight the urgent need for strategic management and reform.

• Current growth rates of the NDIS are unsustainable, requiring reforms to reduce growth to more manageable levels.
• National Cabinet set an interim growth target of 8%, but further reduction is necessary for long-term sustainability.

"Getting growth down from 22% to 8 will certainly be a substantial achievement. And while there are promising signs, everything that the government and the agency have put in place over the past couple of years needs to go right to avoid us slipping off that target."

• Achieving the interim growth target is a significant challenge that requires precise implementation of reforms.

• Public perception of the NDIS is mixed, with concerns about inefficiencies and sustainability.
• Maintaining social license is crucial for the scheme's future.

"Seven in 10 Australians do agree the NDIS plays a vital role in improving the lives of disability. But seven in 10 also agreed the NDIS has grown too large and is struggling with inefficiencies and dodgy providers."

• The dual perception of the NDIS as both vital and problematic underscores the need for transparency and efficiency improvements.

• Future reforms will focus on pricing discipline, fraud prevention, and ensuring value for money.
• The government is investing in fraud detection and prevention measures.

"Our government has taken fraud seriously, investing more than half a billion dollars to build the capacity of the agency to identify high-risk claims and prevent fraud against the scheme."

• The investment in fraud prevention highlights the government's commitment to protecting the integrity of the NDIS.

• A significant challenge is the high enrollment of young children with developmental delays or autism, which was not the original intent of the NDIS.
• Calls for a better support system for children with mild to moderate developmental issues.

"Tens and tens of thousands of young children with mild to moderate developmental delay or autism are on a scheme set up for permanent disability."

• The mismatch between the scheme's original purpose and its current use for children with developmental issues necessitates urgent reform.

• Emphasizes the need for collaboration with the disability community to drive reforms.
• Reiterates the principle of "nothing about us without us" to ensure participant-centered reforms.

"That next wave of reform will of course involve the deepest collaboration with the disability community and participants."

• Collaboration with stakeholders is essential to ensure that reforms are effective and inclusive.

• The Thriving Kids Program aims to provide foundational supports for children with developmental delays or autism, diverting them from the NDIS to ensure the scheme remains sustainable for those with permanent significant disabilities.
• National Cabinet has agreed to share funding for the Thriving Kids Program equally between states and the Commonwealth.
• The program's focus is on early identification and intervention, leveraging existing health systems and filling gaps where necessary.

"Diverting this group of kids over time from the NDIS is an important element of making the scheme sustainable and returning it to its original intent, servicing people with permanent significant disability."

• The quote highlights the need to refocus the NDIS on its original purpose and the role of the Thriving Kids Program in achieving this sustainability.

• Early childhood health systems, such as infant and maternal health services, play a crucial role in early detection of developmental issues.
• Programs like Inklings support early intervention by helping parents understand their child's communication and relational differences.
• The government plans to introduce new Medicare items for health checks and therapies to support developmental needs.

"Infant or child and maternal health systems provided by states are usually the first opportunity to make those checks."

• This statement emphasizes the importance of early health checks in identifying developmental concerns.

• Early childhood education centers are key touchpoints for identifying developmental needs and providing convenient support access.
• Initiatives like the Building Early Education Fund aim to integrate services for young children under one roof.
• Programs like Mental Health in Primary Schools (MYIPS) and Positive Partnerships support education professionals in managing developmental delays and autism.

"Early childhood education and care is also a crucial touch point for families and that will become even more important as we move towards more universal provision."

• The quote underscores the role of early education centers in supporting early childhood development and the importance of universal access.

• Parents need consistent, trustworthy information to effectively support their children's development.
• The government plans to create a nationally consistent online information service to guide parents in seeking help for developmental concerns.
• Existing resources like the Raising Children Network and Autism What Next website provide valuable support and information.

"Parents obviously want to do everything possible to help their kids thrive, but they do need consistent information that they can trust."

• This highlights the necessity for reliable information sources to empower parents in supporting their children's development.

• The government is committed to rolling out the Thriving Kids Program by July next year, with full implementation over the following 12 months.
• Collaboration with states, service providers, and parents is essential in designing and implementing the program.
• The program aims to ensure children with mild to moderate developmental delays receive appropriate support outside the NDIS.

"I want thriving kids to start rolling out from the 1st of July next year. The ramp up of services and supports will be completed over the following 12 months."

• This quote outlines the timeline for the program's implementation and the ongoing commitment to providing suitable support for affected children.

• The program must address regional disparities in service access and workforce availability to ensure equitable support across the country.
• Design work is ongoing to model the number of children needing support and to develop financing and scheme design.

"We do need to start work on with states because this work has drifted. But I also want to reinforce my sense of the urgency of this."

• This statement stresses the urgency of addressing regional disparities and the importance of collaboration in developing the program.

• The Hunter region and South Australia were early pilot sites for the National Disability Insurance Scheme (NDIS), providing insights into the program's potential trajectory across the country.
• Challenges exist in deploying workforce resources to regional areas, highlighting the importance of leveraging broader systems like primary care and early childhood education to improve access for parents.

"Parts of Australia like the Hunter or South Australia more broadly were early launch sites or pilot sites for the NDIS in relation to children."

• Early implementation in specific regions offers a glimpse into the NDIS's future nationwide impact.

"There are challenges getting workforce out into the region and that's why as much as possible I think leveraging mainstream broad-based systems like primary care uh infant and maternal health systems that states run schools early childhood education and care is going to provide a much better system of access uh for parents including in regional Australia."

• Addressing workforce challenges in regional areas requires integrating broader health and education systems to improve access.

• The Thriving Kids program is not merely a rebranding of foundational supports but a focused initiative to help children thrive, targeting specific cohorts as identified in the Bonahadi and Paul review.
• A single nationally consistent program is preferred over multiple state-level programs, with ongoing funding commitments beyond the initial five years.

"Foundational supports is is a generic term I think you take from the Bonahadi and Paul review um to describe a system of supports that would be targeted at quite different cohorts."

• The program aims to provide targeted support for different groups, including children and adults with severe mental illness.

"We are focused on helping those kids thrive. that's what we should be focused on as to where states are at."

• The program's focus is on ensuring children thrive through targeted support.

"We want to hold the pen on this with them. uh we think that it's far preferable to have a single nationally consistent program for thriving kids rather than eight different programs developed at state and territory level."

• A unified national approach is emphasized for consistency and effectiveness.

• Federal government efforts include legislative reforms to make the aged care sector investable, aiming to alleviate hospital pressures by enabling new aged care infrastructure.
• Increased funding for state hospital systems and the development of urgent care clinics are part of the strategy to relieve hospital burdens.

"We passed legislation through the parliament at the end of the last year that that frankly delivered once in a generation age care reform."

• Reforms aim to make the aged care sector attractive for investment, addressing infrastructure needs.

"This year we've increased our funding to state hospital systems by 12%."

• Significant funding increases are intended to support hospital systems under pressure.

• The NHMRC is conducting a review of clinical guidelines for gender affirming care, with expedited advice requested on puberty blockers.
• The review aims to provide updated, expert clinical advice to guide state-level decisions on gender affirming treatments.

"I announced in January, I think, that I'd asked the NHMRC to undertake a review of the clinical guidelines around what's described as gender affirming care for children and teenagers."

• A comprehensive review is underway to ensure guidelines are based on the latest evidence.

"I've also asked the NHMRC to expedite some advice about the use of puberty blockers obviously um for teenagers."

• Expedited advice on puberty blockers is sought to address urgent concerns.

• The PBS is under pressure due to a surge in new, complex, and costly therapies, necessitating a review of health technology assessment systems.
• Efforts are underway to modernize the PBS to continue delivering affordable access to innovative medicines, with new medicines seen as key drivers of productivity in the healthcare system.

"The PBS is is um deeply important to a Labor government. It's deeply important to Australia."

• The PBS is a cornerstone of Australia's healthcare system, crucial for affordable medicine access.

"I recognize we do need to modernize our HTA system to ensure that for another eight decades Australians can enjoy one of the best medicine systems in the world."

• Modernization efforts aim to sustain the PBS's effectiveness in the face of new medical developments.

• The current growth rate of the NDIS is unsustainable, with efforts focused on reducing growth to more manageable levels through increased discipline and integrity.
• Future reforms will draw on existing reviews to ensure the scheme's sustainability and effectiveness for people with disabilities.

"The current growth rate for the NDIS of 8% by July next year is unsustainable in the medium and long term."

• The unsustainable growth rate necessitates significant reforms to ensure long-term viability.

"We've got to introduce more discipline and integrity into this scheme."

• Introducing discipline and integrity is essential for the scheme's sustainability and effectiveness.

• The need for pricing discipline in NDIS services is emphasized, highlighting high charges by registered suppliers for services like occupational therapy and psychology.
• A call for independent pricing systems similar to those in hospitals and aged care to ensure fair pricing and eliminate distortions in service delivery.
• The alignment of pricing between NDIS and aged care services is crucial due to the significant crossover in services and providers between the two sectors.

"I think we will look very seriously at independent pricing in this scheme of the type that we have had in hospitals now for over a decade and have more recently developed in aged care."

• The quote underscores the intent to implement independent pricing systems in the NDIS similar to those in hospitals and aged care to ensure fair and reasonable charges.

• The sustainability of the NDIS is linked to its social license, which is threatened by perceptions of the scheme being too large and out of control.
• The disability community's pride in the NDIS is acknowledged, but there is concern about the impact of negative perceptions on participants.
• Government ministers are committed to ensuring the scheme's long-term future and addressing issues like dodgy providers.

"There is a growing belief in the community that it's got too large. It's out of control. There are too many dodgy providers in it."

• This quote highlights the community's concerns about the NDIS's size and integrity, which could affect its social license and sustainability.

• Clarification on the shift from foundational supports to the "Investing in Kids Now" scheme, focusing on children under nine with developmental delays and autism.
• The intent is to provide tailored support for different cohorts, including adults with severe mental illness, while maintaining the original goals of foundational supports.
• The government emphasizes its commitment to the foundational supports' intent despite changes in program names and structures.

"I do accept that today what I'm doing is indicating on behalf of the Commonwealth our intention to lean more heavily into the design of that part of the program for kids."

• The quote explains the government's focus on designing programs for children under nine, aligning with the foundational supports' goals.

• The NDIS was designed for individuals with significant and permanent disabilities, not encompassing all Australians with disabilities.
• There is recognition that alternative systems meant to complement the NDIS were often defunded, affecting support for those not eligible for the NDIS.
• The government acknowledges the need for diverse support systems for varying levels of disability.

"The NDIS was for people with permanent significant disability. It was always understood broadly what that number would be."

• This quote clarifies the NDIS's focus on significant and permanent disabilities, acknowledging the need for complementary systems for others.

• The government is taking steps to address medical misogyny, focusing on women's health and ensuring gender considerations in medical research.
• Funding for longer GP consults has been provided, particularly benefiting female GPs and women patients.
• The need for embedding sex and gender considerations in government-funded research is recognized, though not yet mandated.

"We did fund a level E consult. So, more than 60 minutes for GPs. We funded, I think, a very good rate."

• The quote highlights the government's efforts to support longer GP consults, addressing concerns about adequate compensation for such services.

• The Medical Research Future Fund (MRFF) has a strategy to allocate $650 million annually, but recent allocations have been lower.
• The government remains committed to the fund's allocation despite past challenges with low interest rates affecting returns.
• A recent review of the MRFF aims to ensure funds are distributed effectively and promptly.

"We're committed to doing that then obviously it's a matter for the health and medical research office to get the funds out the door."

• This quote reflects the government's commitment to the MRFF's allocation strategy and the need for efficient fund distribution.

• The impact of screen time on child development is still debated, with the government adopting a precautionary approach.
• Measures like removing phones from schools and setting minimum age requirements for social media access are in place to mitigate potential negative effects.
• The government acknowledges the need for further research on the effects of screen time and social media on young children.

"We're adopting the precautionary principle I think as a government and trying to do everything we can to free kids from those devices as much as possible."

• The quote emphasizes the government's cautious approach to managing screen time and its potential impact on children's development.