A 'no-fault' cerebral palsy pension scheme would benefit all Australians

The Australian Federal Productivity Commission is proposing two new schemes to better support those with major disability. The main National Disability Insurance Scheme (NDIS) will provide long-term care and support for the disabled. A smaller scheme, the National Injury Insurance Scheme (NIIS), will provide ‘no-fault ‘support for those following an accident or ‘medical injury’. It is proposed that cerebral palsy (CP) is part of the NIIS. While this brings quicker and more equitable benefits to CP families, the scheme labels CP as a ‘medical accident’ and infers preventability. Obstetricians will fund much of the system. Despite being labelled a ‘no-fault’ system, maternity staff can still be litigated for extensive ‘head of damages’, eg loss of earning capacity. An additional option is for federal/state legislation to introduce a true ‘no-fault’ lifetime pension specifically for all children on CP registers. This pension would be graded by degree of disability and dependent on waiving civil litigation. Savings in medico-legal costs and potentially a 7% reduction in caesarean delivery would cover the estimated annual cost of $50 000 per annum indexed life pension for severe CP cases and the total annual cost of AUD $93 million for Australia. This pension and the NDIS would help cover the needs of children with CP without recourse to prolonged litigation and without detriment to the maternity services of Australia, caused by defensive obstetrics and maternity hospital closure because of CP litigation.Alastair H. MacLenna