Insidious Travel Distance, NDIS Behaviour Support, and Regional Australia
Access, choice, and control in regional Australia and across northern NSW relies on stronger travel policies that take large distances into account.
For example, in the New England North West of NSW it is extremely common to rely on services by travelling from one regional centre to another – especially to see a specialist service.
Case in point, it is common for Inverell people to shop in Armidale, 1.5 hrs away, and to go to Tamworth, 2.5 hrs drive, for other essential services not available in Inverell. Armidale people go to Inverell as well. In fact people rely on neighboring regional centres such that they form part of local identities much like residents of large bush estates rely on neighbours who may live far away. But then again distance is rated differently in the bush.
Many services are sought across regional centres but health and allied health services commonly require a great deal of travel.
It is also more common for professionals and specialists to travel in regional Australia. Of course we think of the flying doctors. Nurses also travel extensively. But this is very true for mental health and disability specialist therapists. The latter is all the more relevant for people with disabilities because therapists often prefer to see these clients in their own environment where there is greater chance to observe natural functioning without the added stress for the client that comes from travel to a foreign or clinical setting.
Over the past many years behaviour specialists have travelled across northern NSW under state government funded initiatives because that policy acknowledged the incidious nature of regional travel as a vital life line for regional Australian’s access to specialist disability supports. The policy also followed best practice in evidence based outcomes. Visiting people with disabilities in their own homes or community generally attaches better outcomes.
Many feel the NDIS has not yet generated an adequate funding policy for regional Australia, which does not fall into the remote policy definitions.
What exists so far may not reflect the reasonable and necessary needs of regional Australians. Naturally for the new Scheme existing policy arises from an urban centered model, and applies notions from the urban-based health sector, without acknowledging the critical and historical differences the disability and regional sectors present that either make service provision viable or fall flat on its face.
To reduce if not eliminate this layer of travel and service quality support to regional Australia is to effectively reduce access to specialist behaviour support and other therapies.
Such services may not ever exist in smaller regional centres. Travel will always be an issue.
It is simply not viable to set up a clinical service in most areas of northern NSW. This is unlikely to change in the near future.
This means travel across region to access specialists or for practitioners to visit clients will likely remain the norm.
In the same light, certain NDIS services will not likely expand with the market due to certain geographic, regional, and economic reasons, and will require policy initiatives to support regional access. Other methods will need to be employed to maintain the limited number of viable independent specialist services the region can sustain as a market niche.
Add to this discussion the fact that the former state model saw three tiered services with local practitioners, specialist behaviour support supplied regionally, and an added statewide senior specialist backup system, networked across levels. The current reality in NSW is by no means matching pre Scheme measures.
People who need a service are often encouraged to go back to their Support Coordinator, NDIS Planner or Local Area Coordinator and put up a change of circumstances review.
Sad as this is for a family in need, it is the only way the Scheme will register these needs, and eventually come up with better ways to measure allocations for behaviour support or other therapies.
Having said all of this, in our opinion the NDIS is an impressive vision and historic accomplishment. We are only on the cusp of NSW formal transfer this July, and yet so much progress is evidenced already.
As vital as this remains for so many, progress so far has a way to go before the sector can actually sustain services for regional Australians and for high needs complex cases. Even for those others who require periodic specialist supports the current system is falling short.
But we live in hope.
