Let us start this article with an apology to the interpreters of Australia. In my last article I stated that they were grumbling about the changes to their pay and conditions that have been introduced by the National Auslan Booking Service (NABS). I meant not to offend and it was a poor choice of words. They have legitimate concerns and this article will try to explain some of those concerns. In the debate as to whether NABS should be kept out of the NDIS I am keen to get accurate
e information out there. I may err and if I do please correct me.
To the CEO that wrote in taking umbrage that I had mentioned a memory of an old article that suggested that most funding for disability organisations was swallowed up in management costs, overheads and let’s add consultants … I apologise not at all. For too long large disability agencies have had too much control as to what services and how much service a person with a disability can get. The NDIS aims to give more control over funding to the client with a disability. Have they fully achieved that yet? No, but that objective is a good thing. It is all about choice and control.
This article aims to try and explain the concerns of interpreters that have resulted from the introduction of the NDIS. The aim is to further inform the Deaf community and Deaf sector. I want the Deaf community and Deaf sector to better understand that the changes that the NDIS brings with it raise a number of challenges for the interpreter industry.
An open letter from NABS released on 27th June suggests that the decision to place medical interpreting within the NDIS rests solely with the Minister responsible. NABS also note that they have known of the transition of NABS services to the NDIS umbrella for the last three years. They claim that repeated requests to meet with the Minister concerned have been denied. NABS state that they have lobbied hard to keep NABS as it is. (Click on the blue writing for the full text of the NABS open letter.)
It is the view of NABS that they are a service similar to the Translating and Interpreting Service (TIS) that services Culturally and Linguistically Diverse Communities. (CALD) NABS feel that their service does not fit into the NDIS criteria and is more aligned with TIS services.
Despite NABS protestations the Government has clearly classified Auslan interpreting in medical situations, and indeed all situations, as a disability issue. As NABS note, the decision has been made by the Minister responsible and only the Minister can reverse the decision.
The NDIA have to work with what they are given as do the Deaf community. NABS note that as a result of this Government decision they have received significant funding cuts. Consequently they have had to make decisions about capping services and changing how interpreters are paid. Clearly it has not been an easy road.
Indeed the capping of services is already having ramifications. A number of specialist medical services that Deaf people have previously booked interpreters for have been cut. I understand that some of these specialist services include occupational therapy, X-Rays and naturopathy to name a few. NABS indicate that interpreting funded by NDIS plans will cover the services that have been cut. While this may sound good it does not help those Deaf people who are not within an NDIS roll-out site or have chosen not to have an NDIS plan. Indeed for many the NDIS will not be a reality until 2019. These cuts have left the treatment of many Deaf people in limbo.
It would seem from the NABS letter that the Government aims to phase out NABS. While this will not occur fully until 2019 it clearly has ramifications after 2019. What this means, as alluded in the previous Rebuttal, medical interpreting for people over 65 or Deaf people not on NDIS plans is an unknown quantity after this date.
The crux of much of interpreter concerns comes down to the conditions that the NABS are imposing on them as the result of the Ministers decision. The Minister has instructed that Deaf people who receive NDIS packages must use these funds to pay for private medical interpreting.
The criteria for using NDIS funds for medical appointments is apparently the same as the current NABS model. It can’t be used for public hospitals, it must be a private medical appointment, there are conditions around how interpreters can be used for hospital stays and so on. While NABS doesn’t cover everything it provides a good service and an appropriate remuneration. This remuneration recognises the unique conditions that interpreters work under. It takes into account travel costs and time to travel so that interpreters are adequately compensated when they travel. This means they can service regional and rural areas too. This was the old NABS anyway.
The introduction of the NDIS has led to pay structure changes. The NDIS has made the decision that interpreting services can be billed at a maximum of $115 an hour. Unless an interpreter is booked direct they will not receive the full amount because agencies receive a fee to cover management and booking costs.
I understand, as the result of the introduction of the NDIS, that NABS have reduced the minimum booking from 1.5 hours to just one hour. There have been other reductions in the payment of travel time and so on. These changes will impact on the pocket of interpreters who can least afford it. I have been informed by an interpreter that they stand to lose up to $15 600 through the changes to pay and conditions that interpreters have had imposed on them by NABS.
In the previous Rebuttal we established that Deaf people over 65s can still access NABS. We have established that Deaf people not on NDIS packages, or not in an area that the NDIS is currently rolling out, can still access NABS. In theory no Deaf person should be disadvantaged but this is far from the case. We now know some specialist medical services where NABS previously provided interpreters have been cut. We do not know whether all people who are Deaf will be expected to have an NDIS package to access medical interpreting after 2019. We do not know the fate of access to medical interpreting for people over 65 after 2019. Very clearly the new pay structure introduced by NABS is severely disadvantaging interpreters. There is much uncertainty.
Ill try to give a few examples here of how interpreters are disadvantaged. Minimum booking time previously was 1.5 hours. What this means is that if an interpreter worked for 30 minutes they still got paid for 1.5 hours of work. Now this has been reduced to an hour. That means if an interpreter was to do four medical jobs in a day they would lose two hours of pay. Over a week that’s one full day of pay that they have lost. What this may lead to is that interpreters will simply not do medical jobs. They will do jobs that compensate them adequately like education or employment.
The reduction in the minimum booking requirement by NABS also means that if there are huge delays in seeing a doctor, as is often the case, after one hour the interpreter might simply have to go because they have another job waiting. The current 1.5 hour minimum at least provides greater flexibility. All of these changes could mean, in the long run, less interpreters for medical jobs. This has the potential to put Deaf people at risk. It is a real concern.
I understand that NABS have changed conditions in a a number of other areas such as reductions in payment for periods of waiting and the abolition of reimbursement for parking and tolls. The end result is that the interpreters income is being severely reduced. It seems that all of these changes that have been introduced were more or less imposed on interpreters with no consultation and only one week until the changes were due to start. The bottom line is that if an interpreters standard of living is impacted by reduced income they may get jobs elsewhere. This may leave fewer interpreters available to work for Deaf people.
The NDIS rolls out may mean that many interpreters may choose to go solo rather than go through an agency. They will do this because they will be able charge the full $115 an hour rather than have to be paid at the agency rate. It might seem that $115 per hour sounds a lot but interpreters work under unique conditions.
For example most interpreters are usually only able to work a maximum of 4 hours/jobs per day in the medical field because of travel time between jobs. As a result, for a full day, many interpreters really only earn $57.50 per hour. From this interpreters going solo have to cover their own insurance, administration costs, car expenses, preparation time and ongoing professional development among other things. They also must put money aside for sick days and holidays. It doesn’t leave much left over.
As was pointed out in the previous Rebuttal the Deaf person has the right to choose who they book and with whom. Deaf people on self managed packages can even book any interpreter they see fit whether or not they are registered as an NDIS provider. The only condition is that the interpreter have an ABN. As a Deaf person I like this control but interpreters are right in being concerned that this will impact on quality control and the continued skills development of interpreters.
Agencies, including NABS, provide professional development and ensure that interpreters that are allocated to jobs have the skill set to do that job (in theory anyway.) The NDIS claim that they have a rigorous process for registering as an agency or interpreter as a provider under the NDIS and they do. The NDIA also, rightly in my view, claim that the Deaf person knows who is best for them. This is why many have preferred interpreters.
But for interpreters this is a real concern because medical interpreting is a specialist field. An interpreter who is inadequately skilled could place the Deaf person at risk through interpreting medical information wrongly. Interpreters, many who have spent years and a lot of money honing their skills, are well within their rights to be concerned about this lack of quality assurance.
They are very fearful of an influx of “cowboys and cowgirls” that may see the NDIS as a means to make a quick buck. I have already seen one piece of marketing material where an interpreter has set themselves up with the line that goes something like- See me for your NDIS needs.
One must also consider that interpreting work is largely seasonal. During holiday periods there are often down times for interpreters where there are very few jobs. This means when they are in demand they must maximise their income. If interpreters are being hit in the hip pocket they will seek other employment. This will mean less interpreters for a system that already cannot meet demand.
Changes to payment for travel time may mean interpreters are less likely to want to travel. This may mean that Deaf people in rural areas and the outer suburbs will miss out. The reality may well be that interpreters will just decide to give medical interpreting a miss and choose the more stable jobs that provide a better income. If this happens the Deaf community may be put at risk in many medical situations. Some interpreters may simply give interpreting away altogether.
Lets look at some of the issues that the Rebuttal has established with todays article and yesterdays article.
- People who are Deaf and use Auslan as their primary means of communication are seen as people with a permanent and significant disability. They are eligible for NDIS services.
- Deaf people who are not currently on NDIS plans can continue to access NABS services as usual.
- Deaf people over 65 will be able to continue to access NABS services.
- Deaf people who decide to establish an NDIS plan must use funds for interpreting to pay for medical interpreting. If they become very sick requiring extensive treatment and more interpreting is needed then packages can be renegotiated
- There is a question mark as to what will happen after 2019. It seems that the aim of the Government is to phase out funding NABS completely and use only NDIS packages to fund medical interpreting. This raises questions in regard to medical interpreting for Deaf people over 65 and also Deaf people who choose not to access NDIS packages after 2019.
- There are flaws in the “self managed” packages in that Deaf people can basically book whoever they want and are comfortable with. Quality control and monitoring of “unqualified” interpreters will possibly become an issue.
- The NDIA, on their own admission, have very few case studies to go by. This means developing an appropriate assessment tool to work out how much interpreting is needed is problematic. It will take time.
- NABS have received significant funding cuts and have had to drastically change conditions in how they remunerate interpreters.
- These changes mean that interpreters will be paid significantly less. This is a concern for many of them.
- Changes to conditions and the NDIS pay structures MAY mean that interpreters decline to service areas where there are significant travel costs involved.
- Ultimately interpreters need security. If this can not be provided they are likely to choose work that remunerates them appropriately. Indeed some may actually leave the profession altogether leading even greater stress on a system that cannot meet demand.
- NABS and many in the Deaf sector see NABS services as the equivalent of services that are currently provided to CALD groups through TIS. Consequently NABS believe that medical interpreting should be funded separately from the NDIS. The Minister responsible clearly disagrees and sees interpreting as a disability issue and not linguistic one.
- New NABS rules has seen a cut to the specialist services that they will provide interpreters for. This is already raising questions as to how deaf people will continue with ongoing treatment that they may be receiving.
This is where we are at. The Minister has made a decision that is unlikely to be reversed in the short to medium term. If the Deaf community and the Deaf sector believe they are being disadvantaged they must collectively lobby and collate evidence to show that they are being disadvantaged by that decision. The NDIS is in the difficult situation that it must implement some not well thought out decisions from the Minister.
Luckily the NDIS was developed to be a flexible system and the NDIA have indicated that they want to liaise closely with the Deaf community to attempt to address any concerns. Whether this will be enough in the long run is anyone’s guess. All we can do is to continue to inform ourselves and make an honest attempt to find solutions before rejecting the NDIS as am alternative for medical appointments outright.
That said there is likely to be a great deal of pain and anguish in the meantime before consensus can be reached.
*** Note that even under the NDIS there are still limits to accessing the hospital system, particularly public and emergency situations that are not covered. The long hard road for advocacy in this area has to continue.
*** This article was developed with assistance from professional interpreters impacted by the changes documented.