Welcome to Your Nightmare – The One None of Us Were Told About
What do you get when you suddenly move a complex system into the hands of those who know nothing about that system, just their own?
A policy nightmare, it seems.
Right now, under the guise of solving regional workforce shortages, the government is rolling out a plan that fundamentally destroys the core promise of the National Disability Insurance Scheme.
It is called the ‘Integrated Care and Commissioning Initiative’. It sounds like harmless bureaucratic plumbing, but the raw skeleton of this, once the flesh and bureaucratic wank is stripped away, is chilling. The government is actively running trials in six regions across the country to strip individualised NDIS funding away from disabled people, pool it together with aged care money, and hand it to large regional providers as a lump sum.
They are bringing back block funding. And worse, they are pushing to merge disability and aged care under one roof.
The architecture for this rollback is sitting in plain sight. In September 2025, the Productivity Commission released an interim report titled Delivering quality care more efficiently.
The report pushes the government to break down the walls between disability support, aged care, and veterans’ care. It recommends “collaborative commissioning” (government speak for paying one provider to do everything) and explicitly calls for a “single set of practice and quality standards” for aged care and the NDIS.
To save you having to read this travesty, I’ve pulled out a fast summary and what it means for disabled people;
One Big Watchdog: The report suggests looking into combining the NDIS Quality and Safeguards Commission with the aged care and veterans’ watchdogs to create a single, massive regulator. Many people who gave feedback to the inquiry warned that a single regulator would likely lose its specific disability expertise. This raises the real fear that the unique, human rights-based needs of disabled people could be ignored or treated the exact same way as aged care.
Less Choice of Workers: The report highlights a strong push to make provider and worker registration mandatory across the board, particularly for things like supported independent living and support coordination. While the stated goal is to stop unsafe workers moving between systems, forcing everyone to register formally could drive many independent or unregistered support workers out of the sector due to the cost and paperwork. For participants, this could mean a severe drop in the freedom to choose who comes into their homes to support them.
Tracking Your Lifetime Cost: Perhaps the most dystopian part of the report is the plan to build a massive actuarial microsimulation model. In plain English, this is a computer program that uses linked government data to predict exactly how much money an individual will cost the system over their entire lifetime. The government wants to use this to track peoples service use and target specific groups just to reduce their future drain on the budget.
The NDIS as a Budget Problem: Throughout the entire document, the care system is framed as a looming financial crisis. The report warns that care spending is growing so fast it will outpace government revenue. It bluntly states that the government will either have to raise taxes, increase out-of-pocket costs, or reduce costs by limiting access to care services if things do not change. This makes it clear that saving money is the primary goal, which is a terrifying prospect for people who need high levels of funded support to live their lives.
Massive Data Risks: To make it easier to track workers and providers across disability, aged care, and childcare, the government wants to build a single digital portal to hold everyones information. The report openly admits that putting all this data into one central system carries a massive risk, noting that the consequences of a data breach or hack would be graver than for sector-specific portals.
They’ve also framed the workforce issue as a single issue, which just involves better training – because ‘care’ is all the same, and certainly the same as support, right?
I am pretty sure they do not know what disability support looks like, let alone the medical vs social model.
Aged care and disability support are not the same thing. They require entirely different frameworks, different training, and different human rights protections. Blending them into a single, watered-down standard is a recipe for institutional neglect.
Before the NDIS, Australia relied on block funding. The government gave millions of dollars directly to large charities and service providers, and disabled people were forced to take whatever scraps those providers offered.
If the service was terrible, you could not leave, because the provider held the money. If you wanted to live independently but the provider only offered group homes, you went into a group home. It was a system built on charity and control, not rights and independence.
The entire point of the NDIS was to flip that power dynamic. By giving the funding directly to the individual, the disabled person became the boss. If a provider delivered poor support, the person could take their funding elsewhere. They’ve removed the connection between SDA and SIL, but in a rationed, competitive, underfunded environment – and a cost of living and housing crisis – there is no chance of any disabled person in disability housing having any level of choice or control.
Block funding removes that choice. Handing regional disability funding over to local aged care or health hubs traps disabled people in a monopoly. It turns them back into passive recipients of whatever care fits the provider’s budget, rather than citizens directing their own lives.
By pooling NDIS and aged care money, the government is incentivising the co-location of disabled people into aged care facilities. Their own internal policy on Young People In Nursing Homes said that we should have no younger people in nursing homes by 2025. It’s probably a blessing for the government that so many of us were killed in nursing homes during the start of the pandemic.
We already know the tragedy of younger people trapped in residential aged care. It strips people of their autonomy, their peers, and their connection to the community. Yet, through grants for “minor capital works” and “transition plans”, the government is actively funding existing providers to physically and structurally combine these services.
They are using the very real crisis of regional workforce shortages as a Trojan horse to warehouse disabled people, train aged care workers as disability workers and vice versa and, according to some, develop some block funded Frankencare monster that is part aged care, part veterans and part disability.
What could go wrong?
Well, a lot, the UK says, in this report. But we’ll unpack that in a minute. Commissioning [Integrated] Care in England: An Analysis of the Current Decision Context – PMC
And it seems that nobody has been quite as silly over there as to conflate disability – a completely different system, centred around rights, citizen choice and control, etc – with health. Because, as disabled people say – we are not sick. And we have fought for eons not to be warehoused in God’s waiting room, the nursing homes and institutions that we fought to get out of.
This is not a future threat. The trials are happening right now in the Kimberley, Gippsland, Central West Queensland, and other regions.
Coupled with the massive legal changes buried in the NDIS Amendment Bill 2026 currently before the Senate, the writing is on the wall. The government wants to move away from individualised, rights-based support, and returning to a cheaper, highly controlled, institutional-medical model.
The Senate committee reporting date for the NDIS Bill is June 16. Submissions to the Senate Inquiry is the 29th of May. We cannot let these changes pass quietly. We cannot allow a single set of standards to erase the specific human rights of disabled people, and we cannot go back to the block-funded dark ages.
Read the legislation. Look at the Productivity Commission’s blueprint. Submit your objections to the Senate. We fought too hard to get out of the institutions to let them build new ones in front of our eyes.
Handing entire regions over to massive corporate entities is effectively privatisation by stealth. As disability advocacy group JFA Purple Orange has warned, the sector already suffers from a ‘vanilla market’ where rigid pricing forces providers to offer identical, uninspired services. Integrated commissioning will supercharge this. It commodifies disabled people, turning them from citizens with buying power into units of cost on a corporate ledger.
This is worse than traditional government block funding. Under this model, we are outsourcing the government’s bureaucracy to private monopolies that are incentivised to standardise care, cut corners, and pocket the surplus.
We do not have to guess what happens next; we just have to look at England. The UK has spent years pushing Integrated Care Systems (ICSs) to force collaboration across health and social care.
That stark analysis from Oxford University above (published in PMC9541117) exposed the reality of this model. Instead of local, community-driven care, the English system created a nightmare of red tape. The researchers found that different agencies could not even share basic data. Worse, investment decisions were not based on what patients actually needed; they were dictated by strict, top-down budget caps.
The evidence against this model is pretty clear. This system creates massive bureaucratic bottlenecks where funding is swallowed by middle management and compliance reporting, rather than paying the support workers on the ground. Australia is blindly lifting a failed idea from the UK playbook and Frankencaring it together with the ideas of big charities, many of whom have no capacity to assist with delivering support safely, let alone well.
The foundational promise of the NDIS was ‘choice and control’. If you did not like your provider, you could fire them and hire someone else.
Integrated commissioning kills that principle stone cold dead. If a mega-provider holds the monopoly contract for all supports in your town, you have no choice. The Queenslanders with Disability Network (QDN) has highlighted the terrifying conflict of interest this creates. If there is only one provider in town and their care is unsafe, where do you go?
When massive providers hold monopolies and funding gets tight, they ration care. They force people into cheaper group homes. They dictate when you eat, when you shower, and who comes into your house. Imagine not knowing who was coming to help you have a shower today – it could be a stranger, a man or a woman. Or to change your tampon, or wash beneath your foreskin.
Imagine having that stranger be in your bedroom and not knowing if you’ve forgotten if something goes missing or if it’s stolen or even if the person would do it, because you do not know them. When disabled people are stripped of their choices and forced into substandard, one-size-fits-all care regimes, neglect thrives. People fall through the cracks, and people die.
We had a Disability Royal Commission into exactly these models, about, oh, fourteen minutes ago. Clearly some of the Ministers in charge did not pay attention. It has taken decades of struggle, work and money to move away from them and make the right kind of change. Now they want us to go back to the 1970s.
This model is doomed to failure and poorer outcomes. We must not let the government use rural service shortages as a Trojan horse to privatise and dismantle the NDIS.
Disabled people know exactly how to reduce the NDIS and keep the core principles alive – not the peak bodies, but the grassroots groups, those sitting on groups like the PRG and people who have spent a lifetime working in policy reform. Some of them have even made websites to help them understand it. www.ourndis.org
We won’t go back.
If you want to help, find out how to make a submission at www.dpacaustralia.net
Source: A Personal Challenge to Make the NDIS Far, Far Worse? | Samantha Connor AM | Linkedin
Sam’s Twitter account – @criprights
