The NDIS, Deaf People and the Doctor – Lets Think About It?

doctorDeaf Australia  released a petition today. They are concerned that the Government is considering incorporating the National Auslan Booking Service (NABS) under the National Disability Insurance Scheme (NDIS). For those that do not know, NABS is the Government funded interpreting service that Deaf people who use Auslan can access when they visit a private doctor or medical professional like their local GP.  The NDIS is the much vaunted disability scheme that is to revolutionise disability support in Australia. Where previously funding was controlled by agencies funding will now be controlled by people with a disability who will then purchase the supports that they require from the “market.”

There has been discussion that NABS funding will be put into the pool of NDIS funds. Deaf Australia are rightly concerned that this will disadvantage many Deaf People. They have put together an Auslan video outlining the reasons for their concerns. You can watch this video here.

If you are hearing or a deaf person who does not understand Auslan, click on the CC icon for the captions.

I share Deaf Australia’s concerns. Certainly under the current NDIS you would have to worry that many, many Deaf people might be left without support. As Deaf Australia point out some Deaf people may not even be eligible. Deaf people over 65 who have never had an NDIS plan will also have no access to interpreting. There are also concerns that Deaf people will have to “predict” how many times they will go to the Doctor. As we all know, illness cannot be predicted. Trying to look into a crystal ball and estimate how many times you will require an interpreter at the doctor is fraught with danger.

However, Deaf Australia object to any consideration of NABS funding being part of the NDIS. I personally do not feel that this is reasonable. Rather I believe that we should have an ongoing dialogue with the Government and the National Disability Insurance Agency (NDIA)  to fully explore the issues and develop a model that MIGHT consider medical interpreting under the NDIS. (NDIA are the agency that administers the NDIS)

I want to point out that I share all the concerns that Deaf Australia have raised. However, I feel there may actually be some positives for bringing medical interpreting under the NDIS umbrella. I feel it is wise that we consider all these issues and others before we reject the idea altogether. So in the interest of informed debate I have outlined some of these arguments.

Currently NABS serves only private hospitals and there are limits, particularly for hospital stays and surgery. It is not an all-encompassing program. Potentially if interpreting under the NDIS was set up to address concerns of DA it could open up the use of NDIS funds for public hospitals. We know that public hospitals SHOULD provide interpreting but often they do not. Access to interpreting in the public hospital system is inconsistent.

It is difficult, particularly for emergency situations, to be able to get interpreters. Dealing with hospital administrative processes and booking systems can be a nightmare. It is possible that this could be improved with a more flexible NDIS funding approach which is controlled by the Deaf patient. I think it is vitally important that we explore the possible benefits of the NDIS in a variety of medical scenarios before rejecting it outright.

When you wake up sick and need to see your GP it is difficult to get a NABS interpreter at short notice. Potentially with control of the funding and the booking, the Deaf patient could book in advance. More than once last year I needed to go to my local GP. Planning ahead I made the appointment as far into the afternoon as I could. I then put in a request for an interpreter that was unsuccessful.

I fully understand that supply and demand is an issue. Getting interpreters at short notice is a problem. This is an ongoing problem for all agencies that provide Auslan interpreters. However,  on one occasion I arrived at the Doctors surgery and as I walked in the door received a text from NABS informing me that there were no interpreters available. Frustrated I vented on Facebook, as I often do. I moaned about the shortness of notice. Ten minutes after my appointment I received a text from an interpreter who is registered under NABS. She let me know that she had only been ten minutes away, was available but had received no communication from NABS. Given that she lived in the region this is puzzling.

I believe that under the NDIS, where the Deaf person is in control, there is scope to develop a system where the Deaf person can go online, look at availability and try to match an interpreter with the time they have secured with the doctor. Indeed you could possibly have interpreters in virtual booths set up specifically for this purpose. The Deaf person, if they can get access to good broadband, could then access interpreters on their mobile devices. There are many possible scenarios that could be explored.

I think this is particularly relevant in emergency situations. Let us imagine someone has had a mental health episode. They are self admitting. At the triage they are going to be asked a lot of questions about their condition. Potentially, if the Deaf patient had control, they could go online and book an interpreter in advance. A family member or friend could even do it for them. They could rock up at the hospital and the interpreter might already be there or be on their way. If there were virtual booths these online interpreters could facilitate communication until a face to face interpreter can be arranged.

Sure there will still be issues of supply and demand. Certainly it wont address all situations but by having control it saves the Deaf patient the need to request that the hospital do the booking and then navigate the minefield of the various hospital booking and administrative processes. We could even set up a trial system before hand to see how it might work.

For me the NDIS potentially provides access for people who are deaf who do not use AUSLAN. Captioning companies might have captioners on call so that people who can’t access interpreters for communication can access captioning on their mobile devices. If there is one thing that NABS does not do at present, that is provide access for non-Auslan users. These people get sick too AND many require communication support.

It is about control and flexibility, all the things the current system is not. You are putting the control in the hands of the Deaf person. It could be as simple as going online making the booking, entering the NDIS account number and payment would be deducted at a later date once the interpreter had made a claim. I, for one, would value having control in this manner.

Now I agree there are concerns but it would be dangerous to throw the baby out with the bath water. I would suggest a think tank to explore various scenarios and concerns and bring these to the attention of the appropriate decision makers. Eligibility, over 65s etc etc should figure prominently in these discussions. I also think it is a very valid argument that it is difficult to predict in advance just how much interpreting might be needed for the doctor in a 12 month period. However, a safety net could be designed for those who get an illness that requires interpreting above and beyond what they have predicted.

I also understand the concerns about the NDIS leading to booking of interpreters who are not qualified. I think this is easily resolved using a simple system that is used by JobAccess where any interpreter must cite their NATTI qualifications and number before being paid. There may also be requirements that interpreters have to show they have met a required number of professional development milestones in a given period. If they do not they can be removed by agencies from any booking system that is developed.

That these concerns exist does not necessarily mean they cannot be dealt with. It does not mean that solutions cannot be found. It seems to me that people may be approaching this in a way that they prefer the devil that they know rather than the devil that they don’t. Even so that does not mean that one should dismiss the NDIS a viable alternative IF the decision makers are prepared to consider and address concerns that are raised.

I have only outlined a few arguments here but my point is we may be rushing headlong into dismissing an idea that may ultimately provide better and more flexible access. It is a debate that we have to have. I can see many benefits for using the NDIS and I think we need to explore them fully.

With respect.

2 thoughts on “The NDIS, Deaf People and the Doctor – Lets Think About It?

  1. Fair comment. The over 65’s can qualify for ACAT or HACC funding (WA, not sure if there is an equivalent in other states). There is also an app already in the making that will allow Interpreters to go online when they have a spare few minutes to aid in ‘incidental’ communication. This app is almost completed after a second complete rebuild. Read more about Comm-Clear on the Comm-Clear Facebook page and view the video.

  2. I am delighted to have received a positive response to a letter copy from NDIS Government to my lobbying of allowing over 65 year old Deaf people to continue to use Nabs after 1 July 2016 . The letter is from Government representative Alison Smith NSiS Group 21 April 2016. ” the Commonwealth government will provide continuity of support arrangements for the remaining people over 65 years who are currently using NABS and found intelligible for NDIS …yay yay yay !!! ” Continuity of support arrangements will provide the same outcomes for clients of NABS programme as they were aiming to achieve prior to the introduction of NDIS” Alison Smith NDIS group Australian Government Department of Social Services (21/4/16)Yayayayayayayayayayayayayay!! Drisana Levitzke-Gray Deaf Australia Nsw

    Lorraine Mulley

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