Disability Care and Support 
Draft Report

Submission to the Productivity Commission

April 2011

The Health and Community Services Workforce Council Inc (Workforce Council) welcomes the Draft Report –Disability Care and Support.  The Workforce Council supports the direction of the Draft Report and recommendations. Here, we take the opportunity to provide some additional information, particularly in relation to issues pertaining to recommendations that relate directly to workforce issues.  
Introduction
The Workforce Council is an autonomous not-for-profit peak body that promotes and supports workforce planning and development in the health and community service industries in Queensland.  We undertake a range of workforce planning and development initiatives with industry stakeholders across the health and community services industries.  We facilitate more than forty collaborative networks, coalitions and alliances consisting of industry representatives from across Queensland to work in partnerships to build workforce capacity, prioritise regional workforce development needs and respond accordingly.  We work with a range of government organisations, peak bodies and other key stakeholders groups to develop a sustainable systemic response to workforce issues.  In addition, the Workforce Council occupies a unique position working closely with the education and training sector through a range of projects and initiatives to ensure industry workforce practices are supported by appropriate educational services, pathways and programs.  In summary, the Workforce Council:

•	Provides information and assistance to our industries and industry partners
•	Provides advice to Government about a wide range of training, workforce development and sector specific issues and policies
•	Supports innovative workforce development strategies
•	Brokers quality professional development in regions across Queensland
•	Advocates the value of our industries within the Queensland Community
•	Develops workforce planning and development products and services
For more information about these workforce initiatives please go to http://www.workforce.org.au/our-workforce-initiatives.aspx
Delivering care and support to people with a disability — workforce issues
The draft report describes a future where there will be significant positive effects on the disability workforce (Overview, page 39) - “The new system will translate to greater pay, more jobs, better working conditions, the capacity for innovative practice, enough resources to do the job properly, recognition of the critical role of employers, more choice of employers and greater satisfaction…” This vision is a best case scenario, some of which is not evidenced by any of the discussions within the report or any other national reports related to workforce issues in the disability and the broader community services and health industries.
Although workforce issues have been considered and responded to in the draft report, the report does not appear to be based on a strong workforce planning and development framework, which will be important for any implementation of the NDIS. Without a substantial and skilled workforce to enact the vision that is the NDIS (and the NIIS), there will be significant barriers to the quality implementation of many of the recommendations as well as for the outcomes for people with disabilities.
Need for sector, regional and organisational change management planning and support
The implementation of the NDIS is likely to impact enormously on every current organisation providing disability services. What defines a disability service will change. There will be an emergence of a wide range of new job roles.  As well, the NDIS may impact on organisations’ fundraising capacity as well as their capacity to engage volunteers, due to a potential change in societal perception about the  purpose of current disability organisations. 
Disability services are often very skilled at surviving by effectively responding to changes in government policy and the regulatory environment.  However, the proposed NDIS changes are about changing the whole culture and framework within which disability services are accessed and provided.  Organisations will need to respond to unprecedented changes in demand that will require high level of skills from management to plan for and implement responses to changes in demand. At times, responsive individualised service provision may not provide stability or efficiency if not managed sustainably by service providers/employers.
Organisations will need to engage with sophisticated workforce planning based on change management modelling and sophisticated scenario planning in order to survive.  Planning frameworks will need to be developed that consider demand factors and barriers to supply. It is also important to carefully consider the impact of NDIS on employment models and retention rates of current workers in the sector. 
Skill needs of the disability support workforce
Career promotion campaigns, training subsidies and immigration of support workers are listed as the solutions to workforce issues that will arise (Draft recommendation 13.1).  Although these are all possible responses to workforce issues, they are only a few of the elements that need to be carefully planned and considered. For example, reference is made to immigration of support workers only in the event of acute and persistent shortages. We would like to think that a situation of acute and persistent shortages can be avoided by careful workforce and industry planning and that ethical international recruitment may play a role in an integrated suite as a solution to issues that will inevitably arise for some service areas and some locations on an on-going basis.
Caution should be taken when drawing conclusions about the skill needs of the disability support workforce in light of the perspectives of some people with a disability and their families who prefer ‘untrained’ support workers, frequently so that they can train them in accordance with the own needs and preferences of specific individuals with a disability, their families and/or the disability service.  Currently, many disability services recruit on the basis of ‘soft skills’, such as a responsive attitude to the needs of others; however this should not imply that they do not recognise that other complex skills and capabilities are important.  There is a need to ensure that some level of consistency is maintained through skills and workforce development in a number of areas.  
It is also important not to operate under the assumption that people with disabilities and their families will necessarily understand or immediately have the capacity to manage support workers and the appropriate boundaries, legalities, industrial relations implications, occupational health and safety standards, etc, that shape the employment context.  Sometimes “we train them how we like them” may be at the expense of the support worker’s rights and/or health and safety issues.  In this respect, support workers working for individuals and families, outside of a service context, must  has sufficient knowledge and skills that enable them to strike a fine balance between providing person-centred support and maintaining professional boundaries, managing risk and other dimensions of the relationship where they may, ultimately, be held personally liable.   We need to ensure that through these reforms we are creating the best possible environments for people with a disability and meaningful job roles for support workers.
The need for disability workers to have appropriate skills and professional development opportunities will need to be carefully considered.  As a specific example of a new skill area with NDIS, appropriate skills development of staff undertaking assessments will need to be carefully ensured. Given the high level of expertise that will be required for NDIS assessment services, it is also likely that this will draw workers from other areas of the current disability workforce.  
Needs of carers 
It is important to remember that the informal care workforce is shrinking and represents the same shrinking paid workforce that will be responsible for driving Australia’s economy in the future.  While formal system capacity is a critical issue, building the capacity and scope of the informal care system must remain a top priority.  
The draft report endorses training and counselling for carers and referral to carer support centres (Draft recommendation 13.3).  In our experience the demand from carers for support in relation to planning for the future (i.e. planning for the time when they will no longer be able to provide support for their family member) is one example of high need as well as of current service provision. 
It is also possible that more people may identify as carers, i.e. family members who have withdrawn from the system may now emerge creating more demand for training, counselling and information services.
Given the substantial role that informal carers already play in the provision of care and support for people with a disability, it is essential that avenues be available for education and support that will assist them in their roles.  It is important to emphasise that these opportunities should be highly responsive to the particular needs and quality of life outcomes for informal carers and the person/people they support.  Some families will also need to understand how to manage a workforce and the appropriate boundaries, legalities, occupational health and safety standards, etc.  
The Workforce Council would support the introduction of a strategic initiative to ensure that informal carers receive education, respite, support and advocacy services to assist them in carrying out their roles.  Not only must the opportunities be available, a streamlined system to access information on opportunities available is critical if informal carers are to be supported appropriately in their roles 
Informal carers need opportunities to access a broad range of services including education and training, respite, counselling and peer group support and advocacy services.  As a facilitator of a wide range of workforce development initiatives across Queensland’s health and community services, the Workforce Council has built up a significant evidence base surrounding the need to ensure that informal and formal workers receive a mix of skills development, professional development and other opportunities to support them in their roles.  Formal training and/or access to one-off workshops are not sufficient to create and sustain positive change in practice.  
It is also important to consider the suitability of existing formal education and training options for informal carers.  Existing VET qualifications and administrative systems may create significant barriers for the informal care workforce to participate in VET.  Further, informal carers are more likely to require education and training that is immediately relevant to the individual context of care.  There is a need for the development of approaches to education and training, within or outside of VET, that is meaningful and relevant to this cohort of learners and that does not rely on the completion of full qualifications.  
To ensure that the approach to teaching and learning is appropriate for an informal care cohort, collaboration between training providers, employers, local carer networks and other relevant stakeholders would be essential.  
Conclusion
A holistic workforce planning and development strategy will need to be developed to support the introduction of the NDIS. 
A model developed by the Workforce Council for use across the community services and health industries has identified eight headline issues:
1.	Worker attraction and retention
2.	Workforce investment
3.	Workforce shortages and workforce participation
4.	Service and policy reform
5.	Organisational management and leadership
6.	Rural and remote workforce shortages
7.	Governance
8.	Quality education and training
This is an example of the type of framework that would need to be developed to respond to the workforce challenges offered by the introduction of the NDIS.