E&OE TRANSCRIPT

SUBJECTS: NDIS funding for music and art therapy

JUSTIN SMITH, HOST: So, yesterday, back to the concerns about the future of art and music therapy through the NDIS. Bill Shorten is the NDIS and Government Services Minister and also member for Maribyrnong. Minister, good morning.

BILL SHORTEN, MINISTER FOR THE NDIS AND GOVERNMENT SERVICES: Good morning, Justin, and thank you for inviting me on to talk about this issue.

SMITH: You're in our Canberra studio. You're missing all the rain in Melbourne today.

SHORTEN: Yeah, well, I hope everyone in Melbourne is keeping dry as they can. But anyway, that's Melbourne.

SMITH: First of all, do you believe in these therapies? Do you believe they work? Music and art therapies?

SHORTEN: Yeah, I think they help people. Absolutely. Listen, I listened to some of your callers yesterday and that's why it was great when you reached out, because you thought this is an important issue, which it is. But I do think that there's a fair bit of misinformation around and so that's why I wanted to come on and straighten things out.

SMITH: Please.

SHORTEN: NDIS participants will continue to have access to music and art therapy. And I'm happy to, in whatever way you want to do this interview, unpack what that means.

SMITH: Ok. No, well, tell us, first of all, has access been reduced to people? Will it be reduced?

SHORTEN: What's going to happen is that if you have, at the moment, people can claim – or music and art therapists can get paid $193 an hour to deliver an hour of music or art therapy to a person on the Scheme. What we're doing is if you have that in your current plan, and remember there's – every person on the Scheme has an individual plan, that will remain till the end of your current plan. So, that's the first thing. If you're getting it now in your plan, that doesn't change. The second thing that we're doing is that from February 1st, how people access music and art therapy will change. What we're going to do is that there'll be two ways you can get it. One is if you have stated in your plan, and because it's reasonable and necessary and based on evidence, in the specific circumstances that it's helping you maintain or improve your functional capacity, you'll continue to access your supports at the high rate of $193 an hour. But even if it's not necessarily changing your functional capacity, you'll still be able to access it at a cheaper rate of $68 an hour when it's delivered by a registered provider, and where this registered provider delivers it to a group of four in the hour, they can charge $194. So, all we're seeking is outcomes for the money that we're investing. And at the moment, some of the therapy is so expensive that some people just miss out on accessing it at all.

SMITH: Okay, well, I mean, if you don't mind, it's a touch confusing because it either works or it doesn't work, because in the current you're saying if you've already got a program and you're set up for it, then you can stay on that program for $193 an hour and carry it through. But the changes are going to be kicking into February. So, either $193 is way too much and that's going to be continuing and the system's going to be rorted, or people who need to have that one on one therapy per hour are going to have that cut from February. You see what I'm saying? It's one of them.

SHORTEN: Yeah, I understand what you're saying. So, I'll be as really clear as I can. I'm sorry if I'm adding to any confusion. What I'm saying is that if you currently have it in your plan, it stays till the end of your plan. People have our plans for one year or two years. So, if you're getting it now, nothing changes till the end of your plan. After that, we just need to see it demonstrated that it's actually helping you in terms of your capability. Music and art therapy can help at different levels. Now, I've, you know, I'm aware that for, say, young children with autism, there's some pretty good evidence which shows that the music therapy really does help create quite significant impact. So, that's great. And so where it's related to a therapy, then it stays at the $193 rate. Where it is a social activity which people get enjoyment, where they get activity, where they get social interaction, it'll be charged at the community rate of $68 an hour. So, if it's not, I mean, the rules about therapies and accessing the $193 therapy is that you have to be able to demonstrate that it's reasonable and necessary in the specific circumstances. It's giving you an outcome. So, all we're saying is, if it's working for some people, great. If it's an activity for others, great.

SMITH: Minister, that surely would have been the case, though, that they were demonstrating that it is working for people? Are you saying that the system is being rorted?

SHORTEN: I'm not saying it's been rorted, but there's been insufficient scrutiny on outcomes for participants. What's happened is that my predecessors created a price guide, and so it's an input, and so people just charge what they can, and that's fine. But the reality is I'm interested in outcomes for participants, not just paying people whatever is on a price guide. And where people in the art sector are saying this is making a difference to the kids or we can see it demonstrated then that's fine, that's great. But what we're not doing is just signing a blank check and saying because you do a music class that therefore you automatically get $193.

SMITH: Respectfully, I don't think anyone has ever suggested a blank check should be signed. But from February, do you expect fewer people will be accessing art and music therapy through NDIS?

SHORTEN: No, I don't, because actually, at $193, not everyone can afford it in their plan, at 68 bucks, more people are going to be able to access it. And by the way, when we talk about this, just so we've got some perspective, there's 680,000 people on the Scheme. At the moment, 7,000 do some form of music therapy. It's – $16 million is paid out annually. Like, this is not about budget cutting. That amount of money is not the issue. What we want to do – and it's not just in the music sector – we've been, for the first time ever in the Scheme, we are now clarifying what you can spend money on and what you can't spend money on. We're setting up an expert advisory committee from 1 July to test, you know, if people say their therapies are working, great. But what we will do in the meantime is if a person's plan expires and their music therapist, their registered music therapist, working with their, say, speech pathologists or OTs or others say that we can demonstrate that this is helping the person. Great. Well, you'll still be at the $193. By the way, I know some people say that $68 is not much money, but the registered nurses work at 40 bucks. I get that people have studied a Masters in music therapy. I respect that. I think it does work in some cases.

SMITH: Well, they're concerned that you don't, because, I mean, is that going to be from February, but is that going to be from February, that these therapists who have trained and have been working with people are now going to get a pay cut? A pay cut that they weren't expecting.

SHORTEN: Well, wait, they were never – we just don't pay people because they're good people or because they've trained. It's the outcome they have for the participant. This is not a Scheme for professionals, this is a Scheme for disabled people. Now, I happen to think that some of these therapies are very good and do make a difference, but it is not unreasonable to say on behalf of participants, on behalf of families with scarce budgets, we just want to make sure that what is being promised is being delivered.

SMITH: Well, who's going to make that call? You say that there's a committee, what, in July it’s going to be visited?

SHORTEN: Yeah. In the meantime, we have a technical and an advisory branch. We've been making these calls – or the agency, it's a statutory body, not me. And I don't think politicians should be picking what therapies are right and wrong. Can't we just go back to evidence, science, proof, rather than, oh, well, I want this, or I think this? I mean, subjective assessment is sometimes not necessarily the only reliable guide of what's working. But in the meantime, we have a branch of the NDIS and people, when they put their plans in and say a participant, where they've got art and music therapy, where the plan says, listen this is reasonable and necessary, we've got evidence that this is helping the participant, they'll continue to access it at the higher rate, but just, you know, what's wrong with asking to see, is it working? Is that a bad thing?

SMITH: No, no, but I guess that people are feeling that they are at the moment, they are doing a good job. Look, I guess.

SHORTEN: I’m sure many of them are, by the way.

SMITH: Well, let's go back. Could this have been communicated to them better?

SHORTEN: Oh, well, I heard some of that. We notified changes – there's been 7,000 submissions. The Australian Music Therapy association took part in a consultation in the review they made a submission on when we were also doing the list of therapies as we were finalising them. Sure, no one wants any change at all. And to be honest, if the services that are being charged out at $193 an hour of a disabled person's package, maintaining or improving someone's functional capacity, then it's fine.

SMITH: Okay, well, let's be clear on that, then. So, if a person is receiving therapy right now, whether it's art or music therapy, and it is working for them and the therapist is doing a good job, there will be no change for them?

SHORTEN: And they demonstrate, yeah, if the evidence is there, that's fine. And the thing is –

SMITH: And how do they provide that evidence?

SHORTEN: Oh, well, experts know how to write reports. Believe me, the NDIS doesn't lack for people writing reports, but it is not unreasonable to ask for outcomes. But, you know, to summarise this important discussion, one, I think art and music therapy is a good thing and it's still in the Scheme. There'll be two levels of payment. If you already have it in your plan until your plan expires, it'll be paid at the level it was after that, when your plan expires, if you can demonstrate, if the therapist working with the allied health professionals can show that it's reasonable, necessary, that in the circumstances it's assisting someone's functional capacity, they can continue to access supports at the higher rate and they can have that debate.

SMITH: Respectfully, Minister, respectfully, Minister, that's where it gets a little vague. That's where it becomes a touch vague, which is. Oh, yeah, but if you can prove that everything is fine, nothing will change.

SHORTEN: Yes, but – I love it when journalists say respectfully. A little banter. In all seriousness, it's not vague. The problem is you can't just keep billing 193 bucks an hour if you're not getting an outcome.

SMITH: Yeah, but – okay, all right, well, we'll touch on that again, look, thank you very much for your time. We appreciate it. Look, you're on the way – I'm going to say on the way out the door, but that sounds very disrespectful. But you are leaving politics at the next election, are you? Does that give you some form of a relief after interviews like this, or?

SHORTEN: No, I love this job and I love the NDIS and I'm very committed to making sure that the NDIS is – I mean, along with leading Labor Party has probably been my greatest privilege – I love the NDIS. Before I came along, it didn't exist. I understand when there's any change at all, it creates anxiety. But I just want to say to participants on the Scheme, and indeed to qualified therapists, music therapists, it's going to be ok. We've just got to show what we're getting and how it's working. And I, you know, we'll work it through. There's no hubris. We'll just work it through.

SMITH: Thank you, Minister.

SHORTEN: Thank you. Cheers, mate. Talk soon.

SMITH: Bill Shorten, Minister for the NDIS and Government Services and also the Member for Maribyrnong.