The multi-volume report of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability states
The Royal Commission was established on 4 April 2019. This marked the culmination of many years of campaigning and advocacy by people with disability and their supporters and advocates. Six Commissioners with diverse backgrounds and experiences were appointed to conduct the inquiry.
• Our terms of reference require us to inquire into what governments, institutions and the community should do to prevent and better protect people with disability from experiencing all forms of violence, abuse, neglect and exploitation across all settings and contexts.
• They also require us to inquire into what should be done to promote a more inclusive society that supports the independence of people with disability and their right to live free from violence, abuse, neglect and exploitation. Our terms of reference expressly recognise people with disability have the ‘right to the full and equal enjoyment of all human rights and fundamental freedoms’.
• During our inquiry, we held 32 public hearings and two ceremonial sittings; conducted more than 700 engagement activities; received 7,944 submissions and held 1,785 private sessions.
• We adopted a trauma-informed approach to our work. We aimed to safeguard and promote the physical, social, emotional and cultural safety of everyone who engaged with us. ...
The Royal Commission’s terms of reference are extremely broad. They require us to inquire into what governments, institutions and the community should do to prevent and better protect people with disability from experiencing all forms of violence, abuse, neglect and exploitation, across all settings and contexts.
Our terms of reference also require us to inquire into what should be done to promote a more inclusive society that supports the independence of people with disability and their right to live free from violence, abuse, neglect and exploitation. As noted, they recognise that people with disability have the right to the full and equal enjoyment of all human rights and fundamental freedoms, and specifically refer to the CRPD.
The terms of reference also emphasise the importance of ensuring people with disability are front and centre of our inquiry. They commit us to consider the multi-layered experiences of people with disability associated with age, sex, gender, gender identity, sexual orientation, intersex status, ethnic origin or race. They also commit us to consider the particular situations of Aboriginal and Torres Strait Islander and culturally and linguistically diverse people with disability.
The Commission's recommendations are identified in the following post.
The Report states
Nature and extent of violence, abuse, neglect and exploitation
• There are around 4.4 million people with disability in Australia, or 18 per cent of the total population. Reflecting that disability increases with age, the number of people with disability falls to 2.4 million when we look at people aged under 65 years. This is 12 per cent of this age category.
• Around 35 per cent of First Nations people under 65 had disability in 2018–19, which is nearly three times higher than the general population. Children accounted for almost one-quarter (24 per cent) of all First Nations people with disability.
• As at 31 December 2022, there were 573,342 participants in the NDIS.
• Across all age groups, people with disability experience considerably higher rates of violence than people without disability. People with disability also experience violence more frequently. This is unacceptable.
• Rates of violence are particularly high for: o women with psychological or intellectual disability o First Nations women with disability o young women with disability. • Neglect of people with disability occurs in multiple forms and across different stages of their lives. We heard of many instances of people being deprived of necessities of life and assistance with daily activities. We also heard of systemic failures to provide an environment for each person to maximise their potential.
• The data on exploitation of people with disability is limited. However, people with disability shared with us experiences of both sexual and financial exploitation by other individuals.
People with disability in Australia I just want to live a life without harassment and to be treated with respect and dignity.
People with disability are a diverse community. They vary in age, gender, gender identity, race or cultural background, family environment, socioeconomic circumstance, geographic location and the nature of their disability. While many common experiences emerged from this inquiry, people’s exposure to and experiences of violence, abuse, neglect and exploitation are influenced by a range of factors and social characteristics. Understanding the experiences of individuals and groups of people with disability, and the settings in which they occur, is critical when making recommendations to prevent and respond to maltreatment and deliver appropriate and targeted services and supports.
In this inquiry, the Royal Commission adopted the same approach to ‘disability’ and ‘people with disability’ as the CRPD. The CRPD describes people with disability as including: those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.
Number of people with disability in Australia
The best source of data on the number of people with disability in Australia is the Australian Bureau of Statistics 2018 Survey of Disability, Ageing and Carers (SDAC). According to the SDAC, there are around 4.4 million people with disability in Australia, comprising 18 per cent of the total population, or nearly one in five people. Because the Royal Commission into Aged Care Quality and Safety was recently conducted, our inquiry generally focused on people with disability under 65 years of age. There are around 2.4 million people with disability in this age group, comprising 12 per cent of the population under 65 years. The data we present is for people with disability under 65 years of age, unless otherwise stated. It should be noted the Australian Bureau of Statistics and some other sources we have drawn from define disability differently than the Royal Commission. For example, in the SDAC, the Australian Bureau of Statistics defines disability as ‘any limitation, restriction or impairment which restricts everyday activities and has lasted, or is likely to last, for at least six months’. Age and disability The SDAC shows that the older a person the more likely they will have disability: • 8.2 per cent of children (aged under 18) have disability (approximately 450,000 children) • 13 per cent of adults aged 18 to 64 have disability (2.0 million adults) • almost 50 per cent of adults aged 65 and over have disability (1.9 million adults).
Among children with disability: • there are more boys (61 per cent) than girls (39 per cent) • more than half have an intellectual disability (56 per cent) • 56 per cent have what the Australian Bureau of Statistics calls ‘profound’ or ‘severe’ disability. Adults aged 18 to 64 years with disability are more likely to have a physical disability (65 per cent) than another type of disability. Twenty-four per cent of people with disability in this age group have profound or severe disability.
Of the individual groups we paid particular attention to: • According to the Australian Bureau of Statistics National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), around 35 per cent of First Nations people aged under 65 had disability in 2018–19, which is three times higher than the percentage of people with disability in the general population. Children (those aged under 18) accounted for almost one-quarter (24 per cent) of all First Nations people with disability. Among First Nations adults aged 18 to 64, nearly half (45 per cent) had disability. • SDAC data shows 6.6 per cent of people from culturally and linguistically diverse backgrounds under 65 years of age had disability in 2018, according to the limited data available. This is likely to be an underestimate. • Little information is available on the number of LGBTIQA+ people with disability. The Australian Bureau of Statistics 2014 General Social Survey indicates, as at 2014, 30 per cent of people aged 18 and over who identify as gay, lesbian, bisexual or ‘other’ sexual identity had disability.
National Disability Insurance Scheme participants
People have to be under 65 years of age to apply to participate in the National Disability Insurance Scheme (NDIS). The eligibility criteria for the NDIS require a person to have, among other things, a permanent disability resulting in substantially reduced functional capacity and be likely to require support under the NDIS for their lifetime. To qualify for the NDIS, people are therefore likely to have relatively high and complex support needs. As at 31 December 2022, there were 573,342 participants in the NDIS of whom: • half were aged 18 years or under • 61 per cent were male • 35 per cent had autism • 17 per cent had intellectual disability. The diversity of people with disability is examined in detail in Volume 3, Nature and extent of violence, abuse, neglect and exploitation.
Interpersonal violence, abuse, neglect and exploitation
Across all age groups, a greater proportion of people with disability experience violence than people without disability. People with disability also experience violence more frequently. Rates of violence are particularly high for: • women with psychological or intellectual disability • First Nations women with disability • young women with disability.
• More than half of people with disability aged 18 to 64 (55 per cent) have experienced physical or sexual violence, compared with 38 per cent of people without disability in this age group.
• Physical assault is the most common type of violence or abuse (experienced by 45 per cent of people with disability and 29 per cent of people without disability). • The rate of violence by a domestic partner is much higher for people with disability (21 per cent) than people without disability (9.8 per cent).
• The rate of sexual assault of people with disability is double that of people without disability (18 per cent compared with 9.1 per cent). Of people who have experienced violence since age 15, people with disability are more likely than people without disability: • to experience multiple incidents (76 per cent compared with 62 per cent) • to know the perpetrator (81 per cent compared with 69 per cent). People with head injury and psychological or intellectual disability People with some types of disability experience even higher rates of violence. These groups include: • people with head injury, stroke and brain damage (73 per cent have experienced violence since age 15) • people with intellectual disability (67 per cent) • people with psychological disability (66 per cent). This compares with 60 per cent of people with sight, hearing or speech impairment and 57 per cent of people with physical disability. Young adults and children As noted, a higher proportion of people with disability experience violence than people without disability across all age groups. However, rates for younger adults with disability are much higher than for older adults with disability. Fifteen per cent of young adults aged 18 to 35 experienced violence in the 12 months prior to being surveyed, compared with 5.5 per cent of adults aged 36 to 64. People with disability are more than twice as likely as people without disability to experience physical or sexual abuse before the age of 15 (23 per cent and 11 per cent respectively). xx Women with disability experience all forms of interpersonal violence at higher rates than women without disability. They are: • more than twice as likely to have experienced sexual abuse before the age of 15 • more likely to have experienced violence by a previous intimate partner since the age of 15. Compared with men with disability, women with disability are more likely to experience sexual assault, violence and emotional abuse by a domestic partner, as well as stalking. For example, women with disability aged 18 to 64 are more than three times as likely to have experienced sexual assault than men with disability in that age group (29 per cent compared with 7.7 per cent). Women with disability are also more likely to know the perpetrator of violence against them (93 per cent of women with disability compared with 69 per cent of men with disability). Violence against and abuse of women and girls predominantly occur within family and domestic contexts. Women and girls with disability can be exposed to family and domestic violence outside of relationships with intimate partners, parents, siblings and extended family members in private homes. For example, they can be exposed to violence and abuse by support workers and co-residents in supported accommodation and institutional settings.
Women with psychological or intellectual disability experience even higher rates of violence: • 72 per cent of women with psychological or intellectual disability have experienced violence since the age of 15, compared with 54 per cent of women with disability of any type • 45 per cent of women with psychological or intellectual disability have been sexually assaulted compared with 29 per cent of women with any type of disability. Women with psychological or intellectual disability are also at particularly high risk of violence perpetrated by domestic partners.
First Nations people with disability
First Nations people with disability experience higher rates of violence and abuse than First Nations people without disability. The Australian Bureau of Statistics NATSIHS shows First Nations people with disability are more likely to have experienced physical harm or threats of harm in the previous 12 months than First Nations people without disability (22 per cent compared with 12 per cent). First Nations women with disability: • are more likely to be injured by their most recent experience of deliberate physical harm (78 per cent) than First Nations women without disability (63 per cent) and First Nations men with disability (68 per cent) • are more than twice as likely (53 per cent) than First Nations men with disability (25 per cent) to report that a current or previous intimate partner was the perpetrator of physical harm against them in the previous 12 months. According to the NATSIHS, the most common perpetrator of physical harm against First Nations women with disability is a current or previous intimate partner (53 per cent). For First Nations men with disability, the most common perpetrator is another family member (39 per cent).
Culturally and linguistically diverse people with disability
Limited data is available on the experiences of people with disability from culturally and linguistically diverse backgrounds. The data that is available must be interpreted with caution, given the diversity of this group of people. The limited data suggests: • culturally and linguistically diverse people with disability aged 18 to 64 experience more violence than those without disability (33 per cent compared with 23 per cent) • during the first wave of the COVID-19 pandemic, culturally and linguistically diverse women with disability reported higher rates of domestic partner violence including physical or sexual violence (21 per cent) and coercive control (26 per cent) than people from English-speaking backgrounds (16 per cent and 18 per cent, respectively).
LGBTQA+ people with disability
Data from 2014–15 shows people with disability aged 18 to 64 who identify as gay, lesbian, bisexual or another sexual orientation other than heterosexual are almost twice as likely to have experienced physical or threatened violence than those who identify as heterosexual (20 per cent compared with 12 per cent). In 2019, among LGBTQA+ people with disability (this does not include intersex people due to limited sample size) aged 18 and over, rates of violence and abuse: • were higher among those with ‘severe’ disability than those with ‘moderate’ or ‘mild’ disability • varied based on both sexual identity and gender identity. People with disability who identify as LGBTQA+ reported higher levels of violence and abuse by family members than LGBTQA+ people without disability. These risks are even higher for LGBTQA+ people with ‘severe’ disability (81 per cent reported violence inflicted by family members compared with 55 per cent of LGBTQA+ people without disability).
Violence and abuse in public places
Limited data is available on the extent of violence and abuse people with disability experience when going about their everyday lives in public places. However, it is clear from Public hearing 28, ‘Violence against and abuse of people with disability in public places’, that it can be persistent and pervasive. In Public hearing 28, people with disability described: • physical and sexual violence and verbal abuse • threatening or intimidating behaviour, including being physically blocked and followed • microaggressions – that is, apparently minor incidents that cumulatively amount to abuse, including non-consensual filming • verbal and sexual abuse and harassment in online forums, including social media, public and private forums and dating sites. Violent and abusive treatment in public places has a material impact on the health and wellbeing of people with disability. It can cause individuals to modify their behaviours, such as by not going out in public alone and avoiding particular places, activities and people. This includes avoiding travelling on public transport, going to places where alcohol is consumed, and avoiding groups of teenagers and young adults. This has the overall effect of limiting people’s lives and reducing their participation in the community.
Interpersonal neglect and exploitation
Neglect of people with disability occurs in multiple forms and across different stages of their lives. We heard distressing accounts of severe deprivation, including from a very young age, and of people with disability dying as a result of gross neglect. The forms of interpersonal neglect we have identified are often connected to or enabled by systemic or service delivery issues and include: • depriving people of necessities of life • failing to assist people with daily activities • preventing or limiting the opportunity for people to develop personal relationships or friendships, or to engage in community activities • developmental neglect, such as failing to provide an environment for each person to maximise their potential • failing to prevent people being exposed to the risk of violence, abuse, neglect or exploitation. There is no nationally representative data source on neglect of people with disability.
Exploitation
People with disability have shared experiences of both sexual and financial exploitation by other individuals with the Royal Commission. However, the data on the interpersonal exploitation of people with disability is also limited. The Australian Competition and Consumer Commission (ACCC) provided the Royal Commission data under notice on all scams reported to its Scamwatch program between January 2016 and May 2020. The ACCC data shows the average number of people with disability reporting scams increased each year, from 263 reports per month in 2016 to around 419 per month in 2019. People with disability aged 55 to 64 were most at risk, with 30 per cent of reports of scams from people in that age group. The types of scams reported by people with and without disability were largely similar but scams against people with disability were more likely to have a serious financial impact. Volume 3, Nature and extent of violence, abuse, neglect and exploitation sets out the interpersonal and other forms of violence, abuse, neglect and exploitation people with disability experience across settings and contexts and over different life stages, and what it costs them and Australian society more broadly. This includes the maltreatment resulting from systemic and structural barriers, practices and failures.
Realising the human rights of people with disability
• Australia is party to the seven ‘core’ international human rights treaties, including the Convention on the Rights of Persons with Disabilities (CRPD). However, existing measures do not give sufficient effect to Australia’s obligations under the CRPD and people with disability are not adequately protected against violence, abuse, neglect and exploitation.
• To translate the international human rights of people with disability into Australian domestic law, the Australian Government should commit to the enactment of an Australian Disability Rights Act (DRA). The DRA should clearly articulate the human rights of people with disability, create appropriate enforcement mechanisms, and provide access to effective remedies when rights are breached.
• The Australian Government should consult closely with people with disability, disability representative organisations and other key stakeholders about the proposed DRA. It should introduce legislation into parliament as soon as possible following this consultation.
• The DRA should include guiding principles designed to promote and advance the human rights of people with disability in Australia. The DRA should impose enforceable duties to give life to the rights it articulates.
• The Commonwealth public sector should be the primary duty-holder under the DRA, with a mechanism for other entities to opt in. Their duties would include to consider and act consistently with disability rights; consult with people with disability; and promote disability equality and inclusion.
• The Disability Discrimination Act 1992 (Cth) creates little incentive for employers, schools, service providers and other duty-holders to take active measures to prevent disability discrimination. It should be amended to more effectively promote equality and enhance the right of people with disability to live free from discrimination. These reforms would be complementary to the DRA.
Enabling autonomy and access
• Autonomy is a person’s right and freedom to make decisions, control their life and exercise choice. Access means being able to use and interact with information, environments, services and products in a way that suits a person’s needs.
• Reform across settings is needed to better enable the autonomy of, and access for, people with disability. • This includes promoting accessible information and communications, and increasing the number, skills and accessibility of interpreters.
• Supported decision-making should be embedded in guardianship and administration law and practice, and other systems over time, to ensure substitute decision-making only happens as a last resort and in the least restrictive manner.
• Disability advocacy must be funded to meet demand, taking measures to improve the cultural safety of disability advocacy, and enhancing informal supports.
• People with disability face a range of barriers to accessing quality health care. These must be removed by building the capability of the health care workforce, and identifying adaptations and supports required for a person-centred approach.
• All states and territories should have legal frameworks to reduce the use of restrictive practices, with the aim of elimination. This must include taking immediate action to prohibit some practices, including the seclusion of children.
• Non-therapeutic sterilisation of people with disability must be prohibited, unless the person has given their voluntary and informed consent, with support for decision-making if required.
Inclusive education, employment and housing
• As for all people, education, employment and housing are of profound importance to people with disability. They are also areas with both ‘mainstream’ settings and services, designed for both people with and without disability, and disability-specific settings and services.
• Mainstream systems must be significantly reformed to remove barriers to people with disability accessing education, employment and housing, to improve outcomes and to enable meaningful inclusion.
• Commissioners have differing views about whether settings exclusively for people with disability should be phased out over time.
• Some Commissioners regard the separation of people with disability from their peers and the community at large as ‘segregation’, and incompatible with an inclusive society and inconsistent with the Convention on the Rights of Persons with Disabilities. They consider special/segregated schools, ADEs and group homes and similar accommodation should be phased out over a period of time.
• Other Commissioners consider the choices are not between wholly separated and wholly inclusive settings, but are more nuanced requiring consideration of the specific circumstances in which the physical separation of people with disability takes place. They do not consider a more inclusive society for people with disability and consistency with the Convention on the Rights of Persons with Disabilities necessarily requires the phasing out of schools, employment settings or group homes exclusively for people with disability.
Achieving inclusive education
• Mainstream schools need major reforms to overcome the barriers that prevent students with disability, particularly students with intellectual disability, accessing safe, equal and inclusive education.
• The Australian Government and state and territory governments should develop a ‘National Roadmap to Inclusive Education’ for students with disability, detailing outcome measures, targets and actions. Under article 24 of the CRPD, Australia has an obligation to recognise the rights of people with disability to education. However, this inquiry has shown that many students with disability continue to be denied access to safe, quality and inclusive education.
• There is compelling evidence of gatekeeping occurring in Australia. To prevent this, we recommend: • states and territories amend Education Acts (or the equivalent) to create a legal entitlement for students with disability to enrol in a local mainstream school (a local mainstream school is a school that is open to all students who meet geographic and residency criteria, and that does not consider disability status as a precondition to entry) • state and territory governments establish an independent review process to enable a parent or supporter to challenge a refusal to enrol a child or young person in a school • state and territory educational authorities disseminate clear, accessible material for students with disability and their families on their rights, the obligations of schools, and review processes.
Achieving inclusive employment
• People with disability face systemic barriers to obtaining and retaining open employment. Action is needed to: o reform the Disability Employment Services program o increase opportunities for people with disability in public sector employment o leverage the procurement power of governments to encourage inclusive employment practices in the private sector.
• People with disability working in Australian Disability Enterprises (ADEs) often receive far less than the full national minimum wage under the supported wage system. Workers in ADEs should be paid at least 50 per cent of the minimum wage, moving to the full minimum wage by 2034. The opportunity for a person with disability to work, earn a living and participate as an economic citizen is a key component of an inclusive Australia. It has flow-on effects for the person’s ability to access services, support themselves and their family, realise life aspirations and achieve financial security.
• We identified systemic barriers people with disability face to obtaining and retaining open employment. They fall into four main categories: • attitudinal barriers, such as discriminatory beliefs about, stigmas against and behaviours towards people with disability • physical and environmental barriers, including inaccessible workplaces or communication methods • organisational barriers in workplace functions, including failures to make adjustments that workers with disability are entitled to receive • structural barriers, including government programs, policies and practices that create barriers to employment for people with disability.
Achieving inclusive homes and living
• People with disability face multiple barriers to securing accessible, appropriate and safe housing.
• Some people with disability have little choice but to remain in substandard accommodation, such as boarding houses, with limited occupancy rights and oversight. Some experience chronic homelessness. People can be exposed to violence, abuse, neglect and exploitation in these settings.
• Current practices in group homes can deny people with disability their autonomy, choice and control. • Reforms are required to: o increase supply of accessible and adaptive housing for people with disability o increase tenancy and occupancy protections for people with disability o improve regulatory oversight of supported accommodation o improve responses to homelessness.
• People with disability in group homes can be exposed to various forms of violence, abuse, neglect and exploitation. We strongly support the adoption of more inclusive and alternative models of housing for people with disability. A home is central to a person’s dignity, autonomy, independence and wellbeing and a fundamental human right. A person’s home is the place where they should be safe, secure and able to choose how to live their daily life. It is also critical to participating in other areas of life, for example, to obtaining and maintaining employment and to accessing necessary support. People with disability face considerable barriers to accessing safe, secure and inclusive housing. People with disability are denied choice and control over where and with whom they live; fall into homelessness; and are exposed to violence abuse, neglect and exploitation in a variety of living arrangements.
Criminal justice and people with disability
• People with disability, particularly those with cognitive disabilities, are significantly over-represented at all stages of the criminal justice system. This over-representation reflects the disadvantages experienced by many people with disability.
• The over-representation of First Nations people with cognitive disability in custody, particularly in youth detention, is a largely hidden national crisis.
• Australia has international obligations to take appropriate legislative, administrative and other systemic measures to promote the human rights of people with disability, including those in the criminal justice system.
• Children with disability in youth detention have complex needs and are likely to have experienced multiple traumas. They are exposed to an increased risk of violence, abuse, neglect and exploitation while in detention. Placing children with disability in detention, especially children with cognitive disability, increases the chances they will become enmeshed in the criminal justice system. The age of criminal responsibility should be raised to 14, in line with international accepted standards, to avoid this.
• Staff and officials should receive ongoing disability awareness training and support to identify disability. In youth detention centres, this should extend to the needs and experiences of children with disability.
• The risk of indefinite detention for forensic patients is unacceptable. Laws providing for indefinite detention must be repealed.
• The responsibilities of the NDIS and the criminal justice system to provide supports for people with disability need to be clarified. Greater flexibility is required to support transition planning for people with disability leaving custodial settings.
First Nations people with disability
• First Nations people with disability are uniquely marginalised in Australia.
• The experiences of First Nations people with disability cannot be separated from the ongoing impacts of colonisation, intergenerational trauma and racism experienced by First Nations people more generally.
• Due to a complex history of trauma, stigma and shame, First Nations people can be reluctant to identify with disability.
• Significant change is required to dismantle the barriers many First Nations people with disability face to accessing culturally safe and quality services and supports.
• Reforms are needed to address the over-representation of First Nations people in the child protection system and the criminal justice system.
• Barriers to accessing the NDIS in remote areas have resulted in neglect of First Nations people with disability. The NDIA should consult on culturally appropriate assessment and consider modifying eligibility criteria in some circumstances. It should also increase the number and coverage of culturally safe services for First Nations communities through long-term investment and a flexible approach to funding.
• To address systemic policy and service delivery failures, reforms required include: o establishing a First Nations disability forum o improving the Disability Sector Strengthening Plan o developing disability-inclusive cultural safety standards for service delivery o investing in the First Nations disability workforce.
Disability services
• We heard harrowing evidence about violence, abuse, neglect and exploitation occurring in, or in connection with, the delivery of disability services. This primarily related to supported accommodation.
• The risks of exposure to violence, abuse, neglect and exploitation increase when people with disability are isolated and deprived of choice and control over the services they receive, and have limited capacity to raise concerns about the design, delivery, quality and safety of essential services and supports.
• Self-advocacy skills and access to independent advocacy are integral to safe, quality service provision and day to day choice and control. The NDIA should develop a program to connect NDIS participants living in supported accommodation with independent advocacy services.
• The governance and leadership of organisations providing disability services influence how they embed a human rights culture and identify and manage risk, including the risk of maltreatment of the people receiving their services.
• Disability service providers need robust and transparent policies and procedures to detect and respond to violence, abuse, neglect and exploitation. These should support people with disability, their families and advocates, as well as service provider staff, to raise concerns, make complaints and report incidents.
• Skilled and capable disability support workers are crucial to providing safe and high quality services. Career pathways, including remuneration commensurate with skills, experience and expertise, will assist with workforce retention.
• Rigorous disability support worker screening and recruitment processes, as well as effective training and supervision of workers, are also needed to prevent violence, abuse, neglect and exploitation. A national disability support worker registration scheme is recommended to support workforce development.
• A market approach to disability services has not worked for everyone. Urgent discussions are required between governments to develop provider of last resort schemes to meet the needs of people with disability unable to access adequate or appropriate disability supports.
NDIS Quality and Safeguards Commission
• The fundamental purpose of the NDIS Quality and Safeguards Commission (NDIS Commission) is to improve the quality and safety of supports and services funded through the NDIS.
• The number of complaints and reportable incidents reported to the NDIS Commission is continually rising. Greater focus on people with disability at heightened risk of abuse is required.
• The NDIS Commission should: o strengthen its monitoring, compliance and enforcement activities o build sector capacity to prevent and respond to violence, abuse, neglect and exploitation o improve data and intelligence, and information sharing systems o improve access to behaviour support practitioners o enhance provider registration and audit processes o make it easier for people with disability to complain.
Independent oversight and complaint mechanisms
• Violence against, and abuse, neglect and exploitation of, people with disability occur in multiple settings, including public places and domestic and family contexts. Additional independent oversight and complaint pathways are needed.
• Violence, abuse, neglect and exploitation towards people with disability are likely to be under-reported. Barriers to reporting include an existing complaints system that is too complex to participate in without appropriate assistance and support.
• All states and territories should introduce adult safeguarding laws. A related agency should administer information and referral, advice and support, coordination, investigation, public reporting and community education functions.
• Each state and territory should have an independent one-stop shop providing information and advice about reporting violence or abuse towards a person with disability. This one-stop shop should link people to advocacy and other services.
• Community visitors independently monitor services and facilities provided to people with disability and assist with resolving issues or complaints. There should be a nationally consistent approach to their roles and functions. States and territories should urgently implement a community visitors scheme if they do not have one.
• Compared with the general population, many Australians with disability are much more likely to have a ‘potentially avoidable death’ before the age of 65. All states and territories should have a disability death review scheme to systemically review, understand and address the factors that contribute to these outcomes.
• Nationally consistent reportable conduct schemes should operate in all states and territories to help prevent and respond to abuse against all children. These schemes should include disability service providers that deliver supports or services to children with disability, including NDIS providers.
Governing for inclusion
• The complexity and scale of disability policy and reform in Australia requires focused and increased capacity across governments. A new National Disability Agreement between the Australian Government and state and territory governments is required to strengthen coordination and collaboration.
• Australia’s Disability Strategy 2021–2031, the current national disability policy framework, should be reviewed to consider the issues raised during the Royal Commission and the recommendations made in this Final report.
• To improve accountability, an independent statutory body, the National Disability Commission, should be established to undertake robust monitoring and reporting of outcomes for people with disability.
• The National Disability Commission would also support the realisation of the human rights of people with disability through monitoring and oversight of the Disability Rights Act.
• National disability leadership should be strengthened through greater focus and dedicated skills and capabilities. We recommend establishing: o an Australian Government portfolio with responsibility for disability policies and programs o a ministerial position, the Minister for Disability Inclusion o a Department of Disability Equality and Inclusion that has responsibility for national disability and carers policies and programs, including those currently the responsibility of the Department of Social Services.
Beyond the Royal Commission
• The last volume of our Final report recommends key steps for implementing and monitoring the recommendations of the Royal Commission: o the Australian Government and state and territory governments should each publish a written response to the Final report by 31 March 2024 o the Disability Reform Ministerial Council should oversee the implementation of our recommendations o the independent National Disability Commission should provide an annual assessment on the implementation of our recommendations, and evaluate their effectiveness.
• High quality data and research are important for measuring the effectiveness of policy and holding governments and organisations to account. Ways to improve the evidence base for disability policy and services include: o a nationally consistent approach to collecting disability information o improved data collection about people with disability in closed and segregated settings, with communication support needs, and groups with intersecting and multiple disadvantage.
• Conducting a royal commission can prompt significant changes to legislation, policy and attitudes. Some of the key impacts this Royal Commission has had during its term include: o improved access to COVID-19 vaccinations o initiatives to improve the health care of people with cognitive disability o measures to tackle violence against women and girls with disability. • We acknowledge our work is built on the long term advocacy of people with disability and their supporters to improve the lives of people with disability. ...
