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08 August 2022

E&OE

VIRGINIA TRIOLI, HOST: Why are really any Victorians languishing too long in public hospital beds when of course the system is under pressure and those beds are needed? But in particular, why are NDIS participants in there for so long?

That's a question that the relevant Minister, Bill Shorten, the Minister for the NDIS and Government Services would like answered as well, and he joins you now. Bill Shorten, good to talk to you again. Good morning

BILL SHORTEN, MINISTER FOR THE NDIS AND GOVERNMENT SERVICES: Good morning Virginia.

TRIOLI: We've got some figures actually showing how many NDIS participants are stuck in beds. Can you take us through that, and for how long?

SHORTEN: Well, it's- I thought it would be- there would be problems when we got elected, but nothing's prepared me for this situation. There are 283 people who are profoundly disabled. They're eligible for NDIS as of 30 June, and they're in hospital beds for on average 160 days. This is not- this is just bad. It's bad for the participant. It's also bad for the hospital and the nursing staff and the people who've got to provide the care. Hospitals are designed to treat the sick, but if you're stabilised, you're better off being at home or in an appropriate special accommodation than a very expensive hospital bed which also increases your risk of other illness.

TRIOLI: And on average, what is that costing the system, and which part of the system is bearing that cost?

SHORTEN: Well, it's costing the health system and it's costing the participant. In terms of average costs, whilst the average cost of a hospital bed varies, wait for it, it's about $2,300 plus per day. So you can do the maths. If someone's there for 160 days waiting to be processed out of the place, we're talking $320,000 plus. Like, that's just- it's just madness.

TRIOLI: So, Bill Shorten, are you saying that these are people who are only able to access somewhere else in the NDIS funded system because they're becoming eligible now this June? They- have they been waiting all that time to actually get a package?

SHORTEN: Yeah. Yes. I am saying that. There's over 1,400 people nationally. Some people- there might be a few of this population who suffered some traumatic injury and have gone to hospital, and then at that point it's been worked out that they've needed- they've got a permanent, profound impairment. But some of the other people going in there were already disabled and not in appropriate accommodation. 

Either way you cut it, the previous government has just, honestly, ignored the problem. It's- I'm genuinely mystified because this is a- it's a real issue. It's got real consequences. 

Now, I'm not saying that every person has a cookie cutter solution, but I am saying that having started to look at this issue, it occurs to me that the bureaucratic decision making- each decision is dealt with in a sort of linear fashion. You work out, is the person eligible? Then you work out, can they get a planner? Then you work out putting together a care team for when they leave. Then you work out home modifications. But it seems to be a series of consecutive decisions rather than dealing with matters concurrently. 

Again, listeners will be thinking it should be pretty obvious, but I don't know. There hasn't been the will to just resolve this, I think, sufficiently.

TRIOLI: Bill Shorten, are the beds, or the places, or if it's not to be that participant's own home, are they available in the system for them to go to in any case?

SHORTEN: No, in some cases they're not. They have to be found. But this isn't a new problem. So, in other words, if we need to find transitionary accommodation, then that should be done. If there's a genuine problem, and I'm prioritising this as the new Minister, if in the process of trying to resolve the bed block and the delays we come across the fact that there's just simply not enough houses, well, then we'll have to deal with that. But at this point, I'm not convinced it is just an accommodation- lack of accommodation problem. I think the processes are all so slow.

TRIOLI: Did the state hospital system- were they alerting the NDIA to this? Because presumably they would be desperate to get those beds back and that's not the appropriate setting - an acute hospital - for that kind of, you know, ongoing, lifelong challenge. Are you aware of ongoing communication between these state funded hospitals and the NDIA?

SHORTEN: Yes, I am. I think the hospitals have been dealing with this. And of course, it's only ever the bad news which gets on- gets the headline.
I'm sure that there's been- I'm sure there's cases where the system has worked in a speedy and efficient manner, but there's too many taking too long. I'm visiting hospitals. There's very good disability rehab teams at hospitals, and they would work with the agency, the disability agency, to try and find accommodation. But somewhere between the hard working actions are conscientious actions within the system at a hospital to individual to disability agency. Somewhere between those efforts and outcomes, there seems to be this giant pot of glue, bureaucratic glue, which seems to slow everything down

TRIOLI: Is this just an issue in Victoria or are all states and territories dealing with this?

SHORTEN: No, it's an issue everywhere. It is an issue everywhere. In some other states, in Tassie, I think generally it does have an accommodation shortage. So it's perhaps even more acute in a couple of jurisdictions, but it's a problem everywhere.

TRIOLI: Bill Shorten is with you, Minister for the NDIS, talking about those NDIS participants who are stuck in hospital because of bed block and because there's no other place for them to go or it's taken so long for all the elements of their plan to be put together. 

You're building up to a really wholesale overhaul of the NDIA aren't you, Minister? I mean, I'm aware now- I can see sort of like a pattern of information, if you like, from you pointing out the problem here, there, everywhere that seems to be creating an argument to come in and have a wholesale turning upside down that department, that bureaucracy. Is that what you want to do?

SHORTEN: In part. The issue with the NDIS is I don't think the problems are automatically Liberal versus Labor versus Green versus teal versus whatever. I think, in part, this is an agency who the previous government, in my opinion, didn't sufficiently focus on. It doesn't mean there's not a lot of people working very hard in the agency. Doesn't mean that some of the former government's politicians weren't, you know, motivated to do the right thing.

But collectively this agency, in my opinion, at the senior level has been drifting. So there's good people in it. And, of course, they get disheartened when they hear any bad news. But I'm a bit of an optimist. I think if you put all the facts on the table, people of goodwill can work out what to do. So I…

TRIOLI: And will that…

SHORTEN: … more transparency and more co-design will help. I think the answers are not totally hard in some cases. I just think you've got to have the political will to find them and implement them

TRIOLI: And in an already very expensive system that is a massive pressure on the Budget, is part of the answer more money as well? Will a Labor government that's already dealing with a record deficit have to come up with more money to fund the NDIS?

SHORTEN: I hope not, because I think that there's money which is getting wasted. I think there's inefficient processes. We've also got to have a conversation with the states about other issues, not the hospital issue that we're talking about, but I think we need to do more for community mental health funding. I think we need to do- make sure our school systems are delivering as best they can for kids with special needs. 

See, my view is that if the NDIS is the only lifeboat in the ocean, then that's what everyone will try and swim to. So we've got to try and step up some of the extra resource for disabilities because not everyone with a disability is meant to end up in the NDIS.

TRIOLI: Okay.

SHORTEN: Having said that, I think within the actual agency it does need- the people working in the agency need to know they've got a Minister who's as motivated to see it work as they are.

TRIOLI: I just wanted to ask you, you've of course got two big gaps there at the NDIA itself. The Chair, Denis Napthine, he resigned. You, of course, called his appointment back in the day a disgrace when he was appointed; and the departure, of course, of CEO Martin Hoffman. Given what you said about Denis Napthine at the time of his appointment, can we be assured that it won't just be a Labor type or a Labor aligned appointment there for the Chair and also for the Managing Director?

SHORTEN: Yes. And I'll come back on your show when we finalise the process. And if you think that the wrong thing's happened, you'll call me out. But I'm happy to be accountable. Listen, with Denis Napthine by the way, I think the previous government was wrong to put him in as Chair in the shadow of an election. Doesn't mean that he, the individual, doesn't have a contribution to make.

TRIOLI: No, you made that point at the time. You actually- it seemed a bit contradictory, actually, because you were so strident in your language and then you were so praiseworthy of him when he actually left.

SHORTEN: You can be critical of a process which five days before the- eight days before the writs of an election are offered, a major statutory appointment is just made and the states weren't adequately consulted. But that doesn't mean that you have to personalise it against the person per se, but rather the process was poor. And I think a new government should have the opportunity to put in key positions people it feels have gone through the right process.

TRIOLI: Okay.

SHORTEN: But to your point, we'll have a proper rigorous search - we are - for the CEO. And I think that when we announce some new appointments in coming weeks and months to the Board, I think Australians will be interested and it'll hopefully be a decision which people can feel confident about

TRIOLI: Good to talk to you this morning, Minister. Thanks for your time.

SHORTEN: Super, Virginia. Thank you. Bye.

TRIOLI: Bill Shorten there, Minister for the NDIS and Government Services.