Holding the Mirror Up

Values, or should I say behaviours we hold dear at Aspire & Grow is total honesty and transparency. So much so it has taken the last few weeks since the latest NDIS PAPL was announced to take time to fully digest, reflect and attempt to consider the many variables, opinions and emotions at play.

This PAPL hit hard and close to home for Aspire & Grow. Our Clinical Lead and Co-Director is a Physiotherapist of 22+ years experience, who NDIS now places more value to the lives of participants in therapeutic massage rather than an evidence based clinical assessment and treatment.

Why has it taken so long to write this, our first BLOG? Which in itself is a point that the most recent changes has broken me out of my procrastination.

Because I fear the observations and synthesis of the clear outpouring of criticism may either be not welcomed or misconstrued as they are uncomfortable truths.

Contextual points, to state the obvious:

• Failing to address CPI for 7+ years is unique, unacceptable and I, even after much research cannot find any analogous industry that has been subjected to such a freeze.

• NDIS is an Insurance scheme, which is also a pawn for the highest echelons of Government Depts and Politics

• NDIS was never intended for National Providers to build elaborate management and clinical lead structures focusing on performance targets instead of participant needs.

• NDIS is still in its infancy. Whilst the Disability and Health industry has been present for many decades, the NDIS is barely out of nappies.

• NDIS has poorly managed and governed fraud and unscrupulous providers

Observations and convenient omissions of truth:

1. Therapists, as with Support Coordinators are part of the problem.

2. NDIS doesn’t owe any service provider anything.

3. All NDIS service providers ‘Choose’ to operate and continue to operate within the NDIS. They can also ‘choose to leave’.

4. NDIS was never intended for national service providers, nor with tiers of middle management to ‘manage’ therapists to hit target and therapists focused on climbing the career ladder into management rather than participant goals.

The uproar however, which I believe is evidenced as genuine due to the very reason it will further impact the most vulnerable, regional and remote participants is being portrayed without the full honesty of the facts at hand.

Common responses this week cited amongst many providers, chat groups and industry communications unfortunately resonates with entitlement and strives to provide a smoke screen.

Why do I say this:

• History can be a good teacher. Support Coordinators for years delivered pro-bono work due to the care their participants they were serving and aware that the funding they were provided with was already insufficient.

• The impact of this is for years the true cost and skills of Support Coordination has been masked to the NDIS and not until a point of crisis has their been a concerted ‘stand united’ effect.

• Therapy providers, similarly to SCs have underclaimed for services always provisioned for, therefore providing an inaccurate cost of services requires/delivered.

• Therapy providers claim they did this for the ‘benefit of participants’, which is naïve, short sighted and at worst disingenuous. It also demonstrates that therapists are therapists and not business people, which is understandable as they spent years studying and practicing therapy, not business.

• What this achieved was to consistently present to NDIS planners what could be achieved for less. No wonder the model is now being changed to match. It happened with SCs previously, so why the shock now?

• The unspoken truth is many therapy providers failed to charge for permitted services to undercut and deliver cheaper services than ‘competitors’ to gain a competitive advantage. They are now claiming it’s unfair the Therapy model is now being based off the costs they were originally charging.

• It would be nice to see more ownership from those who conducted themselves in this manner assist to find solutions rather than point the finger of blame at NDIS. Hold the mirror up.

So, do I believe the changes are right? Absolutely not.

Do I believe the National Providers and short-sighted independent’s focused on their immediate personal goals have contributed heavily to the situation? 100%

What should or can we do? In business you are taught to embrace constraint and be creative with the resources at your disposal whilst staying true to your values.

Each individual business will have it’s own set of parameters and resources to respond. Our own small family run business has it’s own challenges and concerns. We are only 2 years in, and whilst growing sustainably and quickly we have real concerns and fears. We remain humble and thankful for our network’s support.

Am I fearful for the short term service provision for regional and remote participants at a time when there is a demonstrable skills shortage? 100%

What may success look like? Local clinicians and therapists, supporting local people in their local community.

How? It’s going to take some time. How long? I believe atleast months/quarters but more like years. The fall out hasn’t started yet.

The variables that the large providers have at their disposal include redundancy of middle management, supervisory roles, mandated shift to clinic service delivery and increased KPIs (further impacting participant care & therapist burnout) and merger/acquisition in order to achieve greater economies of scale.

These are my thoughts, reflections and opinions.

Anyone who knows me well I am happy to debate, discuss and consider other viewpoints over a coffee or something a little stronger