SIGNIFICANT reforms are expected to emerge from the Disability Royal Commission.
As with the Aged Care Royal Commission – the final report for which was tabled in parliament on March 1, 2021 – the Disability Royal Commission has heard horrific stories of abuse and neglect by disability providers.
And it is clear that violence, abuse, neglect and exploitation thrive in organisations that lack consumer-focused governance.
The case studies into disability service providers by the Disability Royal Commission make for sobering reading. People with disability – the clients of those service providers – suffered violence, abuse and neglect at the hands of those service providers.
What strikes me is that not one of the relevant executives or board members involved in these organisations got up one day and decided to do the wrong thing or decided not to care.
By my reading, they did care. I would also wager that, before the royal commission called them to account, all would also have said they had the governance piece largely right, that their services were safe and their clients were valued.
What is clear from the case studies is that ‘caring’ isn’t enough anymore. Most of them were looking the wrong way, or in any direction but their client. In fact, in almost all cases, boards had no idea what was happening on the front line in their name.
I put this failure squarely down to a failure to implement a governance that embeds client engagement in all aspects of service planning, delivery, monitoring and evaluation.
There are many in the sector who do this well. But in the cases before the Disability Royal Commission, the lens of the client was disregarded, so opportunities to design and deliver services to provide actual choice and control (key in preventing violence, abuse, neglect and exploitation) were missed.
I see this routinely in my work: good intentions, strong values alignment but working blind. Often this is because the provider has grown so fast its governance has been unable to keep pace, or because the board and executive are preoccupied with finances and the National Disability Insurance Scheme as a business, or because they simply don’t know how to integrate the lens of the person with disability into their DNA.
Lived experience, not just on the board but through all levels of the provider, is still unusual. Care governance is still a hit-and-miss affair, consumer or quality advisory boards are still uncommon, and it is still rare to see a member of the executive with a primary mandate to design and embed the customer through the organisation (even rarer if they have human-centred design and social impact credentials).
The Disability Royal Commission will make governance recommendations similar to what we have seen in aged care reform, but with a disability bent: independent directors, directors with lived experience, advisory committees, quality and safeguarding framework etc.
Many providers are already doing this or, wisely, have started the journey and I have no doubt they will improve the level of governance in the disability sector. However, while these will lift the bar, they will only set a minimum standard.
If providers truly want to serve their missions; if they want to create thriving, profitable, sustainable organisations; if they want to avoid the enormous financial and reputational damage caused by incidents of violence, abuse, neglect and exploitation in their organisations; if they want to root out every bad apple, then they must build a culture and governance framework at all levels that values the people they serve and sees compliance and risk management as enablers.
They must also build an all-seeing, all-knowing governance framework that is multi-pronged and that is lived and breathed every day.
We know this journey is hard and long. We know that with all the resources of the banking sector they still haven’t managed to get it right. Aged care reforms are looming and large disruption awaits.
Bringing the client-focused governance culture to small-to-midsized organisations in the NDIS space will no doubt be a jarring experience. Those unwilling to go on the journey choose their own destiny.
Organisations that take taxpayers’ money and look after others need a social licence, and the bar is getting very high.
• Amber Crosthwaite is a commercial lawyer specialising in seniors living, aged care and disability
