Queensland Advocacy Incorporated
Systems and Legal Advocacy for vulnerable people with Disability
Our Mission: To promote, protect and defend, through advocacy, the fundamental needs,
rights and lives of the most vulnerable people with disability in Queensland.
SUBMISSION
QUEENSLAND COMPETITION AUTHORITY
MEDICAL AND DISABILITY AIDS AND EQUIPMENT PRICING
INVESTIGATION
DRAFT REPORT 2013
Ph: (07) 3844 4200 or 1300 130 582 Fax: (07) 3844 4220 Email: [email protected] Website: www.qai.org.au
2nd Floor, South Central, 43 Peel Street, STH BRISBANE QLD 4101 (PO Box 3302 STH BRISBANE BC QLD 4101)
QAI endorses the objectives, and promotes the principles, of the Convention on the Rights of Persons with Disabilities.
Patron: Her Excellency, Ms Penelope Wensley, AC Governor of Queensland
Contents
About Queensland Advocacy Incorporated…………………………………..3
Our beliefs………………………………………………………………………..3
Introduction……………………………………………………………………….5
Recommendations……………………………………………………………….5
2
About QAI
Queensland Advocacy Incorporated is an independent community-based advocacy
organisation that has for the last twenty-five years campaigned for the rights of vulnerable
people with disability in Queensland.
Objects from the Constitution
The objects for which the Association is established are:
1.
To affirm and put first people with disability in Queensland.
2.
To do systems advocacy that strives to promote, protect and defend the fundamental
needs and rights and lives of the most vulnerable people with disability in Queensland.
3.
To do legal and individual advocacy that strives to promote, protect and defend the
fundamental needs and rights and lives of the most vulnerable people with disability in
Queensland.
4.
To take an active leadership role in advocating for the fundaments needs and rights
and lives of the most vulnerable people with disability in Queensland.
5.
To support, promote and protect the development of advocacy initiatives for the most
vulnerable people with disability in Queensland.
6.
To be accountable to the most vulnerable people with disability in Queensland.
Our Beliefs

All Human life has intrinsic dignity and worth.

People with disability must positively and actively be accorded worth, dignity, meaning
and purpose through being included in and with their community

Social advocacy is functioning (speaking, acting, writing) with minimum conflict of
interest on behalf of the sincerely perceived interests of a person or group, in order to
promote, protect and defend the welfare of, and justice for, either individuals or groups, in a
fashion which strives to be emphatic and vigorous, and/or which is actually, or very likely to
be, “costly” to the actor, eg in terms of: time or other resources
1.
Emotional stress
2.
Bodily demands
3.
Social opprobrium, rejection, ridicule
4.
Self-esteem, self-certainty
5.
Socio-economic security, livelihood
6.
Physical safety, life.
3
And the essential elements of Social Advocacy are:

Strict partiality

Minimal conflict of interest

Emphasis on fundamental needs and issues

Vigorous action

Cost to the advocate

Fidelity

Being mindful of the most vulnerable person.

Systems advocacy is a particular advocacy form what focuses on influencing and
changing the ‘system’ (as in the whole of society and the various systems operating within) in
ways that will benefit people with disability as a group within society. Systems advocacy
include, but is not limited to, policy and law reform activities.

Independent individual advocacy is performed for the benefit of one person, although
systemic changes may be effected as a result of activities undertaken by QAI staff on behalf
of an individual or when several individuals are affected by same or similar systems issues.
Queensland Advocacy Incorporated has a membership base made up of people with
disabilities, their family members, friends and supporters; concerned members of the
community; organisational allies; professional colleagues, and interested parties within the
disability sector including government and academia.
We hold ourselves to account by including people with disability in key management
committee positions, as paid staff, and as members.
4
Introduction
Costs of medical aids and equipment that are the essential supports to people with disability
have been subject of discussion and complaint for many years. Whether these are
incontinence aids, wheelchairs, communication devices or the costs of transportation by taxi,
the financial outlay for such items despite any subsidies are a burden. This burden is
exacerbated by lack of or incomplete information about where to find appropriate equipment
or aids, trialling products, repairs, replacements or upgrades, and the perception of price
disparities between retailers or stockists.
As a result of low employment rates, people with disability are among the most
disadvantaged in Australian society and significantly more likely to be living below the poverty
line. Around 825,000 people with disability* in Australia received the Disability Support
Pension (DSP) 1 and 2013 a single person on the DSP receives up to $751.70 a fortnight,
adding up to less than $20 000 a year.
Employment participation by people with disability has dropped over the last 20 years. 2
Closing the gap in labour market participation between people with a disability and those
without by a third would add $43 billion to the nation's GDP over the next decade, according
to a 2011 study by Access Economics.3 The report said such a move would be achievable if
barriers to employment were addressed.
Fifteen per cent of those with disability who are able to work need special employer
arrangements including equipment, modifications or supervision.4
The 2009 Shut Out report5 confirmed that in some cases employers were unwilling to employ
a person with disability because of the perceived cost of making modifications or purchasing
adaptive technology. The high cost of disability related equipment means that potential
employers, educational institutions and service providers are often able to claim successfully
that purchase of such equipment would be ‘unjustifiable hardship’ under the Disability
Discrimination Act 1992.
Example: A BrailleNote Apex BT 32 Braille Notetaker costs AUD $6150 - or just under one
third of a single person’s annual Disability Support Pension (DSP), yet a recent study has
1
ABC News, http://www.abc.net.au/news/2013‐04‐08/charity‐says‐too‐many‐people‐claiming‐disability‐
support/4615276 2
4102.0 ‐ Australian Social Trends, March Quarter 2012 In 1993, 55 per cent of Australians with a disability were employed, compared to 77 per cent of people without a disability, according to figures from the Australian Bureau of Statistics. But that figure dropped to 53 per cent last year, with 83 per cent of people without a disability participating in the workforce. http://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/4102.0Main+Features40March+Quarter+2012#lfp 3
Deloitte Access Economics. 2011. The economic benefits of increasing employment for people with disability. Commissioned by the Australian Network on Disability, August 2011. 4
Ibid: page 10. 5
2009. SHUT OUT: The Experience of People with Disabilities and their Families in Australia National Disability Strategy Consultation Report prepared by the National People with Disabilities and Carer Council. 5
shown that of the people receiving the DSP, 38% lack at least $500 of emergency savings
and 26% have recently been unable to pay utility bills. 6
Access to equipment is critical to the well-being of many people with disabilities. Access is
essential to employment, education, health and to breaking down the social isolation
experienced by so many people with disability.
QAI commends the Queensland Competition Authority (QCA) for its comprehensive report
“Medical and Disability Aids and Equipment Price Disparities” November 25.
Given the scope of the QCA report we are happy to provide a brief submission supporting
many of the key findings and recommendations, and offer some supplementary
recommendations.
Information Asymmetry
8.1
The Department of Health and Department of Communities, Child Safety and
Disability Services should investigate opportunities to make:
(a) product and price information more readily available to consumers
(b) prescribers more accessible to consumers
With the advent of the NDIS more and more people with disability, their families and
supporters will look toward self-direction and or self-management of funds to procure their
own supports, services and aids and equipment. In fact with the changes to the
Commonwealth Aids and Continence Scheme (CASS) many people found themselves in a
position where they were forced to look beyond their narrow purchasing history and navigate
the maze of information if they could indeed find it.
However, for many people, the information is scant or not complete, online searches are not
accessible to everyone and at times purchasing products has been a trial and error.
While we believe that suppliers of aids and equipment will direct their marketing strategies
towards customers rather than prescribers, some people with disability or family members will
rely on prescribers for particular (perhaps specialised or customised) equipment. Therefore
consumers should have increased access to prescribers, but importantly the role of the
prescriber may be set to undergo significant change.
With reference to the QCA report regarding Market Failure, Exclusive Dealing and Geo
Blocking we suggest that with both online and hard information and advice available to
consumers and their families and or supporters (this can be provided via the Australian Tax
Office (ATO) and or Centrelink communications) will assist to overcome the current
information asymmetries. Consumers should be provided with information about the
means to circumvent such issues (as outlined in the QCA report), and innovative and flexible
prescribers could be enlisted to support their efforts. This could indeed help to overcome the
“free riding” that some suppliers face.
6
ACCAN. 2012. Inquiry into IT pricing Submission by the Australian Communications Consumer Action Network (ACCAN) to the House Standing Committee on Infrastructure and Communications 6
9.2
Governments should consider the following features when designing programs
for aids and equipment: (c) Choice. Choice is important. Consumer-orientated
programs tend to produce better outcomes for people with disability, and can increase
competition and lower prices. However the limits faced by consumers from information
asymmetries must be considered.
We believe with adequate advice and information people will be enabled to make wise and
economically sound online purchases that will afford wider choice on aids and equipment.
Prescribers could offer purchasing advice on the better alternatives for people on whether an
online purchase is suitable over an exclusive dealership with customer service and
customisation is more appropriate. We suggest this as a complementary means of
information and advice to work in hand with the QCA recommendation for a government or
peak body website such as CHOICE etc.
Local suppliers could be encouraged to offer repairs and servicing assistance for online
buyers. This would support their viability as traders as some retail sales may be lost to the
overseas market.
There is a rather patriarchal concern that people with disability and or their families will face
issues with lack of after sales service, ill-matched equipment or aids or financial disadvantage
when purchasing from alternative sources. QAI has had contact with many people who have
faced these issues with the current system. People learn from their mistakes, have gained
experience and become wary buyers as a result of this. Younger people with disability and
their families are already savvy online shoppers and will put their experiences to good effect
in this new arena.
However, we acknowledge that safeguards for vulnerable people who are at risk of
unscrupulous traders may need support to have their complaints addressed and therefore we
recommend that there be an advice and help line to assist with overseas purchasing
complaints.
Government Programs and Price Disparity
9.1
The Queensland Government, in its reviews of government procurement and
the MASS program, should give consideration to:
(c) opportunities to secure lower prices through, for example, direct purchase from
overseas suppliers
and
(f) reducing and streamlining the application process for MASS equipment
We support the findings and recommendations of the QCA as outlined below but suggest that
applications for assistance should be approved with allowances for basic necessities more
reflective of the person’s needs. People should not have to bear the indignity or risk of being
without medical or continence aids.
We reiterate the same recommendations 9.2 for this Section (Government Programs and
Price Disparity – MASS) in regard to choice and opportunity for consumers provided they
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have accessible information and advice and in particular for direct purchase from overseas
suppliers.
9.3
The Department of Health and Department of Communities, Child Safety and
Disability Services should give consideration to establishing a mechanism that would
allow consumers to report pricing disparities for medical aids and equipment.
We endorse the QCA recommendation that there should be a complaints register for reports
of pricing disparities but that there should be actions taken to remediate those disparities
either with the suppliers or the person with disability directly disadvantaged by those
disparities.
10.3 The Queensland Government should investigate ways to increase the supply
and thereby reduce the cost of taxi transportation.
In 1987 the Bjelke-Petersen government introduced a taxi subsidy program for
Queenslanders with mobility impairments, recognizing that mobility is essential to everyone’s
quality of life. More than thirty years later mobility is no less important. Over 61,600 adult
Queenslanders with impaired decision-making capacity need assistance with transport. Many
others with physical impairment require the use of accessible taxis.
The NDIS will not provide all things to all people with disability and many will miss out and
having to bear the high costs that are not met by the current scheme. Since its inception
there has been no real increase in the subsidy which still means that a half price cost is borne
by those consumers who need this transport the most, and who are least able to afford it.
We recommend that not only should the fleet of accessible taxis be increased, but that the
subsidy itself is increased
.
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