The debate around the financial sustainability of the national disability insurance scheme turned to the issue of sex work this week after the NDIS minister, Bill Shorten, vowed to ban it from being funded by the scheme.
While advocates have said this is a “red herring”, the minister has stuck to his guns.
Here’s what you need to know.
Why has the debate about NDIS costs become about sex work?
With the federal budget predicting NDIS costs will rise from $44.3bn in 2024 to more than $90bn by the end of the decade, the Albanese government is trying to put the scheme – which supports more than 600,000 people with disability – on a more financially sustainable footing.
Shorten is seeking the Senate’s support for a bill that forms part of that overhaul. It would allow the government to tweak the NDIS rules to target “plan inflation” – where participants request more money for supports than originally budgeted for. It would also clarify what items and supports can be funded by participants.
To dial up the pressure on the Senate, Shorten told parliament recently about the unusual goods and services that the government wants to rule out from NDIS funding, including: legal cannabis; taxidermy; sex toys; crystal therapy; cryptocurrency, clairvoyance and many others.
On Sunday, Shorten told Sky News sex worker services would also be part of this crackdown.
“We will rule it out, yeah, we will rule it out. It’s just not a sustainable proposition, it doesn’t pass the test, does it?” Shorten said. However, Shorten also said in the interview that the “reality is I’ve got one or two examples” where it had happened.
So can NDIS participants claim sex worker services on the scheme?
In 2020 the federal court ruled the use of NDIS funding for sex worker services met the “reasonable and necessary” test for a woman in her 40s who lives with multiple sclerosis and wanted it included in her plan. Theoretically, it’s been legal since this ruling.
The former Coalition government had fought against having public funds used to pay for sex work services through the administrative appeals tribunal to the federal court, which eventually found the NDIS Act “does not expressly exclude such activities from being funded supports”.
The former NDIS minister under the Coalition, Stuart Robert, criticised the ruling at the time. He also raised the issue of sex worker services in the NDIS several times around the same time the Coalition was trying to make the case to clamp down on the soaring cost of the scheme.
How common is it? And how much is it costing the NDIS?
Shorten told ABC Radio this week there had been 228 requests for sexual activity support in the 12 months to the end of April, but “none were granted”. “So, it’s not as if people are losing all these rights, but what we’re doing is creating regulations, which means that there it’s clear so that people have certainty.”
Shorten said he had “zero interest in anyone’s private life” and it was not a decision about denying people what was “reasonable and necessary”, the key principle that underpins the scheme.
“Use your [disability support pension], use some other money,” he said. “I’m fighting to make sure people get their wheelchairs, their autism therapies, get their home modifications.”
The National Disability Insurance Agency declined to say how many participants had used the funding for sex work services since the federal court ruling or how much it had cost.
Advocates and researchers say, in total, it would be a small number of people – and therefore a very small cost, relative to other services. Sex worker and academic Rachel Wotton, who is completing a PhD on the experiences of people with disability who access sex worker services, says she surveyed 108 participants, of which 18 had used NDIS funding. But of the 27 she interviewed, only five participants had used NDIS funding. The research did not cover when participants had used the funding but she conducted the interviews in 2022.
“Out of those five, two of them had stopped needing or wanting the services,” she said.
“For some people, it will be their only form of touch outside the practical support worker touch needs that occur. And imagine having no touch in your life.”
What are disability advocates and supporters saying about the proposed ban?
River Night, a disability sector advocate, said this week that avoiding the issue of sexuality from support settings “shows a huge lack of contemporary and educated insight into human services”.
“NDIS providers are required to provide ‘holistic’ approaches to service delivery,” Night said. “That includes not just medical support but support for identity, community, relationships and all those things that every human being has a right to.”
Touching Base is an organisation that links sex workers with Australians with disability and offers support to those on the NDIS. The group’s president, Saul Isbister, says the number of people using NDIS to fund sex work services is so low the issue is a “red herring”.
“It has been put forward to garner support for the government in creating limitations on how services may be funded,” Isbister says. “But because of the low numbers involved, this in no way addresses the major issues of sustainability which the government is required to address.”
Isbister criticises the fact all applications for sexual services had been rejected by the NDIA in the past year.
He says it should be acknowledged that some people “do not have the capacity to express or self-pleasure themselves sexually without assistance because of the nature of their disability. Nobody expects people with disability to live the life of a nun.”
What happens now?
Last week, the federal opposition and the Greens teamed up to send the planned reforms to a second parliamentary inquiry. This will delay the passage of the bill by at least eight weeks.
The opposition finance spokesperson, Jane Hume, said recently that the Coalition was likely to support the NDIS reform but further scrutiny was needed.