Letter to the editor
Rehabilitation Social determinants of health Health services administration
Volume 222 - Issue 10

Social inequalities in eligibility rates and use of the Australian National Disability Insurance Scheme, 2016–22: an administrative data analysis

Authors:  George Disney, Peter Summers and Yi Yang

Med J Aust 2025; 222 (10): 530-530. || doi: 10.5694/mja2.52658
Published online: 2 June 2025
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In reply: We thank Quilliam and colleagues1 for raising the issue of equitable disability service provision for people who live in regional and remote Australia. We wholeheartedly agree — this is an area that warrants further research, and potentially policy change.

Given the well documented social inequalities faced by people living in regional and remote Australia,2,3 it would be surprising if these inequalities did not influence access to and use of the National Disability Insurance Scheme (NDIS) in regional and remote Australia. The data we used in our article have information on the area where people live.4 This information could be readily used to disaggregate the NDIS population by regional and remote status so that inequities can be examined.

In line with recommendations by Smith‐Merry and Chan in their linked editorial,5 our analysis of regional and remote access inequalities could be extended to also include the number of times applications were cancelled before submission. If applications are started but not submitted more often in regional and remote Australia than in major cities this could be indicative of a lack of access to affordable specialist assessment in regional and remote areas, which is often required to access the NDIS.

More broadly, with the NDIS reform already well underway, it is vitally important that an equity‐first approach is taken.6 As the operation of the NDIS is changed, researchers, working together with people with disability, could evaluate in real‐time whether these changes are perpetuating or introducing new inequities in NDIS access and service use. If the NDIS is going to deliver on its promise — to support meaningful inclusion for Australians with disability — any change to its operation needs to ensure that the operation of the scheme itself is not reinforcing the already existing social disadvantage people with disability face.


Authors

  • George Disney1
  • Peter Summers1
  • Yi Yang1
  • 1. University of Melbourne, Melbourne, VIC

Correspondence: george.disney@unimelb.edu.au

Competing interests

All authors have conducted commissioned work for the Australian Department of Social Services (National Disability Insurance Scheme [NDIS] service use), the Victorian Department of Families Fairness and Housing (inequalities in NDIS service use), and the Queensland Department of Seniors, Disability Services, and Aboriginal and Torres Strait Islander Partnerships (NDIS service use in regional and remote Queensland).

References

View this article on Wiley Online Library

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