Disability Care and Support

Inquiry report

This inquiry report was released on 10 August 2011. An Errata has been issued with this report.

Download summaries of the report

The overview booklet contains the key points, an extensive summary of the Commission's analysis and recommendations.

If you want to see the detailed supporting material, please download the full report below.

The Commission has also prepared an Executive Summary of the Proposed Scheme, together with Easy English and Plain English versions of this. These can be downloaded below. The Easy English version is written in an easy-to-read way, and uses pictures to explain some ideas.

The Easy English version (PDF - 1254 Kb)

Download the full report

Volume 1 - Disability Care and Support (PDF - 4133 Kb)
Volume 1 - Disability Care and Support (Word/ZIP - 2550 Kb)
Download volume 1 Daisy files by chapter below

Volume 2 - Disability Care and Support (PDF - 2218 Kb)
Volume 2 - Disability Care and Support (Word/ZIP - 2231 Kb)
Download volume 2 Daisy files by chapter below

Download the report by chapters

Preliminaries (PDF - 347 Kb) | (Word - 904 Kb) | (Daisy/ZIP - 11 652 Kb)
- Cover, Copyright, Letter of transmittal, Terms of reference, Contents, Acknowledgments and Abbreviations
Overview - including key points (PDF - 834 Kb) | (Word - 1157 Kb) | (Daisy/ZIP - 49 276 Kb)
Recommendations (PDF - 236 Kb) | (Word - 148 Kb) | (Daisy/ZIP - 24 653 Kb)
Chapter 1 Introduction (PDF - 304 Kb) | (Word - 214 Kb) | (Daisy/ZIP - 13 919 Kb)
- 1.1 What has the Commission been asked to do?
- 1.2 Definitions and some key facts
- 1.3 Ways of thinking about disability
- 1.4 Rationales and objectives
- 1.5 Some design elements for a new scheme
- 1.6 Inquiry processes
- 1.7 Structure of the report
Chapter 2 Why real change is needed (PDF - 413 Kb) | (Word - 753 Kb) | (Daisy/ZIP - 35 369)
- 2.1 Introduction
- 2.2 Disadvantage and disability
- 2.3 Insufficient support provision
- 2.4 Underfunding in the current system
- 2.5 The need for structural change
- 2.6 Conclusions
Chapter 3 Who is the NDIS for? (PDF - 400 Kb) | (Word - 306 Kb) | (Daisy/ZIP - 42 391 Kb)
- 3.1 Introduction
- 3.2 A tiered approach to providing supports
- 3.3 Tier 1 - minimising the impacts of disability
- 3.4 Tier 2 - ensuring appropriate support from any system
- 3.5 Tier 3 - individually tailored funded supports
- 3.6 Taking account of the broader context of service delivery
- 3.7 How many people are likely to receive individualised supports
- 3.8 Implementation issues
Chapter 4 The role of the community and the NDIS (PDF - 276 Kb) | (Word - 167 Kb) | (Daisy/ZIP - 17 252 Kb)
- 4.1 Introduction
- 4.2 The importance of community participation and inclusion of people with disabilities
- 4.3 Engaging the community
- 4.4 NDIS issues
Chapter 5 What individualised supports will the NDIS fund? (PDF - 364 Kb) | (Word - 246 Kb) | (Daisy/ZIP - 39 148 Kb)
- 5.1 Introduction
- 5.2 Specialist disability supports
- 5.3 The role of 'mainstream' services
- 5.4 Income support
- 5.5 The basis for providing specialist disability supports
- 5.6 Means testing, front-end deductibles and co-payments
Chapter 6 Aligning the Disability Support Pension with goals of the NDIS (PDF - 486 Kb) | (Word - 314 Kb) | (Daisy/ZIP - 32 535 Kb)
- 6.1 Reform strategies
- 6.2 Altering expectations
- 6.3 The incentives to work are often blunted by current arrangements
- 6.4 Work bonuses and other approaches to address the fixed costs of working
- 6.5 Social impact bonds and other innovative approaches
- 6.6 Engaging employers
- 6.7 An anomaly: the treatment of the blind
- 6.8 Using data for optimal interventions
- 6.9 Some other presumptions should be re-assessed
- 6.10 Some caveats
- 6.11 More scrutiny of the DSP is needed
- 6.12 What about the Youth Disability Supplement?
Chapter 7 Assessing care and support needs (PDF - 574 Kb) | (Word - 637 Kb) | (Daisy/ZIP - 30 493 Kb)
- 7.1 Introduction
- 7.2 What is being assessed?
- 7.3 What is the purpose of the assessment process?
- 7.4 Desirable features of assessment tools
- 7.5 The current suite of assessment tools
- 7.6 A single tool or a 'toolbox'?
- 7.7 Who should conduct assessments?
- 7.8 When should assessments occur?
- 7.9 Should carers have their own assessment
- 7.10 How assessment might work in practice
- 7.11 Diligent use of the assessment tool
- 7.12 The transition to a fully-fledged assessment toolbox
Chapter 8 Who has the decision-making power? (PDF - 480 Kb) | (Word - 580 Kb) | (Daisy/ZIP - 56 656 Kb)
- 8.1 Person-centred approaches
- 8.2 Defining 'self-directed funding' in more detail
- 8.3 Reasons for self-directed funding
- 8.4 Impacts, benefits and costs
- 8.5 Design of self-directed funding
- 8.6 Exercising power at the family level
- 8.7 What services should be covered?
- 8.8 Self-directed funding needs to be structured carefully
- 8.9 What about spending options in regional and remote Australia?
- 8.10 Employing people directly
- 8.11 Paying relatives for care
- 8.12 Take-up of self-directed funding and the need for support
- 8.13 What about the general risks of self-directed funding?
- 8.14 Implementing individualised funding
Chapter 9 Governance of the NDIS (PDF - 847 Kb) | (Word - 1059 Kb) | (Daisy/ZIP - 56 691 Kb)
- 9.1 Introduction
- 9.2 Defining the scope of governance in the NDIS
- 9.3 The role of the NDIA and others within the NDIS
- 9.4 Creating a National Disability Insurance Agency
- 9.5 Measures to encourage high performance
- 9.6 Why have just one agency?
- 9.7 Managing the funding pool
- 9.8 Complaints and dispute resolution
- 9.9 Other functions
Chapter 10 Delivering disability services (PDF - 417 Kb) | (Word - 309 Kb) | (Daisy/ZIP - 52 574 Kb)
- 10.1 Disability support services
- 10.2 Navigating the disability system
- 10.3 Safeguarding quality
- 10.4 The implications of consumer choice for block funding, government-run services and rural areas
Chapter 11 Disability within the Indigenous community (PDF - 343 Kb) | (Word - 212 Kb) | (Daisy/ZIP - 26 663 Kb)
- 11.1 A snapshot of Indigenous disability
- 11.2 Challenges to supporting Indigenous Australians with a disability
- 11.3 Addressing the high rate of Indigenous disability
- 11.4 Improving support to Indigenous people with a disability
- 11.5 Conclusions
Chapter 12 Collecting and using data under the NDIS (PDF - 417 Kb) | (Word - 291 Kb) | (Daisy/ZIP - 29 155 Kb)
- 12.1 Introduction
- 12.2 Deficiencies in the existing evidence base
- 12.3 Why an effective evidence base under the NDIS is needed?
- 12.4 Data systems
- 12.5 Research
- 12.6 Methods of analysis
- 12.7 Other features of the evidence base under the NDIS
- 12.8 Implementation
Chapter 13 Early intervention (PDF - 161 Kb) | (Word - 304 Kb) | (Daisy/ZIP - 17 362 Kb)
- 13.1 Introduction
- 13.2 Nature and scope of early intervention
- 13.3 The benefits of early intervention
- 13.4 Targeting beneficial early interventions under the NDIS
- 13.5 Interventions outside the NDIS
Chapter 14 Where should the money come from? Financing the NDIS (PDF - 469 Kb) | (Word - 447 Kb) | (Daisy/ZIP - 35 042 Kb)
- 14.1 The money can only come from several sources
- 14.2 Tax design criteria
- 14.3 Tax and revenue options
- 14.4 Ensuring sustainable returns
- 14.5 Fully-funded, pay-as-you-go or a hybrid?
- 14.6 Federal or Australian Government financing of the NDIS?
- 14.7 The Australian Government as the exclusive financier for the NDIS
- 14.8 A pooled funding approach is a weaker alternative
- 14.9 Achieving a fair effort by all jurisdictions
- 14.10 The funding of the scheme is feasible and manageable
Chapter 15 Workforce issues (PDF - 411 Kb) | (Word - 327 Kb) | (Daisy/ZIP - 48 641 Kb)
- 15.1 A snapshot of the disability workforce
- 15.2 Are there, and will there be, labour shortages?
- 15.3 Attracting more workers to the disability services industry
- 15.4 Alternatives to increasing the formal workforce
- 15.5 Are labour supply concerns surmountable?
- 15.6 Qualifications, working knowledge and career paths
Chapter 16 The cost of the NDIS (PDF - 317 Kb) | (Word - 675 Kb) | (Daisy/ZIP - 32 287 Kb)
- 16.1 Introduction
- 16.2 Data
- 16.3 Estimated number of people in tier 3
- 16.4 Costs of the scheme in 2018-19
- 16.5 Scenarios
- 16.6 Cost of the NDIS - 2011-12 to 2018-19
Chapter 17 Insurance arrangements for injury (PDF - 438 Kb) | (Word - 533 Kb) | (Daisy/ZIP - 55 916 Kb)
- 17.1 Introduction
- 17.2 What is catastrophic injury?
- 17.3 Criteria to assess injury insurance arrangements
- 17.4 Certainty, timeliness and quality of lifetime care and support
- 17.5 Coverage of people acquiring a disability through a catastrophic injury
- 17.6 Impacts on recovery and health outcomes
- 17.7 People's freedom
- 17.8 The value of 'justice'
- 17.9 Providing incentives for people to avoid injuries
- 17.10 Efficiency and costs
- 17.11 The performance of common law systems of fault-based compensation
Chapter 18 A national injury insurance scheme (PDF - 572 Kb) | (Word - 515 Kb) | (Daisy/ZIP - 61 077 Kb)
- 18.1 A national injury insurance scheme is needed
- 18.2 Implementing a no-fault approach for lifetime care and support of all catastrophic injuries
- 18.3 How should NIIS claims be financed?
- 18.4 What might the costs be?
- 18.5 The scope of the NIIS beyond 2020
- 18.6 Some other matters
Chapter 19 Implementation (PDF - 252 Kb) | (Word - 145 Kb) | (Daisy/ZIP - 13 436 Kb)
- 19.1 Implementation in outline
- 19.2 Implementation of the NIIS
- 19.3 Implementation of the NDIS
- 19.4 Interaction between the two schemes
Chapter 20 The benefits of reform (PDF - 213 Kb) | (Word - 352 Kb) | (Daisy/ZIP - 30 679 Kb)
- 20.1 What are economic benefits?
- 20.2 The potential economic gains from the NDIS are large
- 20.3 But how much would the NDIS make a difference?
- 20.4 A basic plausibility test
- 20.5 The employment impacts on people with disabilities of the NDIS, DSP and employment service reforms
- 20.6 How many carers could potentially re-enter the workforce?
- 20.7 A more complex analysis of 're-distributive' effects of the NDIS
- 20.8 A wrinkle or two
- 20.9 The NDIS as an insurance product
- 20.10 The bottom line
Appendix A Consultations (PDF - 130 Kb) | (Word - 72 Kb) | (Daisy/ZIP - 4425 Kb)
References (PDF - 378 Kb) | (Word - 334 Kb) | No Daisy version of the References chapter

Please note: The following appendices are only available online and are not in the printed copy.

Just briefly...

Key points

Printed copies

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