In late 2024, the Australian Government sought public input on the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track) Bill No. 2, which proposed strengthening the regulatory powers of the NDIS Quality and Safeguards Commission to improve participant safety, deter non-compliance, and improve service quality. Consultation centred on 10 proposed measures, including strengthening the penalty framework and statutory requirements through new statutory duties, expanding safeguarding provisions by broadening the scope of banning orders, and enhancing the Commission’s information gathering powers to obtain documents and information more effectively.

QAMH’s December 2024 submission welcomed the focus on safeguarding but cautioned against introducing major new obligations without addressing underlying systemic challenges. We highlighted the urgent need for pricing reform, noting that 80% of providers were already concerned about financial viability under existing prices. We also raised the risks of adding new compliance burdens to a sector already navigating multiple standards, particularly given the scale of unmet psychosocial need (with almost half a million Australians lacking access to supports[1]). QAMH argued that reforms must strike a careful balance: enhancing protections for people with disability while sustaining providers’ ability to deliver services, especially in rural and remote areas.

The recently released NDIS Quality and Safeguards Commission Consultation Insights Report reflects the voices of more than 1,000 contributors including people with disability, advocacy organisations, providers, and peak bodies. The report shows broad support for strengthening accountability and safeguards, but also clear concerns about whether the measures are proportionate, given the additional compliance burden and the capacity of smaller and regional providers. Key findings include:

• Penalty framework and statutory requirements: Strong support for tougher measures to improve provider accountability, but concerns that higher penalties and statutory duties could discourage workers or providers from engaging in the sector.
• Safeguarding: Broad endorsement of expanding banning orders to cover more roles, though many stakeholders called for greater clarity and safeguards around their application.
• Information gathering: General support for enhanced powers, but mixed views about practicality, particularly around short timeframes and the proposed requirement for data to be stored in Australia.

Overall, the report reinforces a common theme: reforms must balance stronger safeguards with practical support so providers can continue delivering essential services.

Where QAMH’s Advocacy Made an Impact

QAMH’s submission focused on ensuring that reforms strengthen safeguards without undermining service viability for community mental health organisations. Several of our key messages were clearly reflected in the report:

• Pricing reform is critical: the report quoted QAMH directly, emphasising that “implementation must align with comprehensive pricing reform that reflects the true costs of quality service delivery, including adequate provision for training, supervision and compliance activities.”
• Regulatory burden risks service withdrawal: small providers and those in regional and remote areas could be disproportionately impacted – a concern echoed widely.
• Equity for diverse communities: reforms must be culturally safe and accessible, particularly for First Nations and culturally and linguistically diverse communities, and recognise the vital role of smaller, community-led organisations.
• Implementation challenges: successful reform will require clear information, sector support, and adequate transition time, while also addressing practical issues such as the cost and feasibility of requiring all data to be stored in Australia.
• Rule-making powers: referring to the ability of the NDIS Commissioner to make or amend Prescribed Bodies Rules, the report quoted QAMH’s caution that “there are significant concerns about the appropriate level of oversight and accountability for such broad-ranging powers”.

In addition, the report highlighted broad support for measures to address exploitative marketing, improve fairness in legal processes, and extend banning powers to auditors and consultants, while also noting the need for clarity and appeal mechanisms – consistent with QAMH’s submission.

Issues Still Missing from the Discussion

While many of QAMH’s concerns were reflected, several critical issues raised in our submission were not explicitly captured in the report:

• Workforce inequities: disparities between NDIS workers and those in aged care and other sectors, and how additional penalties could worsen retention challenges.
• Overlap with existing workplace health and safety laws: risks of duplicating penalties under existing workplace health and safety frameworks.
• Psychosocial context: the need to recognise the episodic nature of mental health challenges, and to distinguish between preventable harm and expected fluctuations.
• Staged implementation: our call for reforms to be rolled out gradually was not detailed.
• Co-design and lived experience: the importance of embedding lived experience in developing and applying new rules.

Next Steps

Feedback from this stage of consultation will now be carefully considered by the NDIS Commission to inform the development of proposed amendments to the NDIS Act. Subject to Government approval, an Exposure Draft of the amendments will be publicly released for further feedback before any changes are introduced to Parliament for consideration.

This Exposure Draft will be a critical opportunity for stakeholders to shape how the reforms are applied. QAMH will continue to advocate strongly to ensure the voices of community mental health organisations, and the communities they serve, remain central to the next phase of reform.

QAMH’s inclusion in the NDIS Quality and Safeguards Commission Consultation Insights Report demonstrates that our advocacy is already making an impact, and we are committed to building on this momentum in the months ahead.

[1] Health Policy Analysis. (2024). Analysis of unmet need for psychosocial supports outside of the National Disability Insurance Scheme – Final Report. https://www.health.gov.au/resources/publications/analysis-of-unmet-need-for-psychosocial-supports-outside-of-the-national-disability-insurance-scheme-final-report?language=en