The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (Royal Commission) released its interim report (Interim Report) on 30 October 2020. Extending over 500 pages, the Interim Report sets out the experience of people with disability who have given evidence before the Royal Commission, detailing their exposure to violence, abuse, neglect and exploitation. The direct experience of people with disability is a key part of the work of this Royal Commission.

Broadly, the Interim Report outlines the activities, evidence and observations of the Royal Commission from its commencement, up to 31 July 2020. The Interim Report does not contain any recommendations for the Commonwealth, noting that the Royal Commission is still in its nascent phase and needs to carry out further investigations. We can however, expect a report arising out of the Royal Commission's COVID-19 hearing to be published in November 2020, with that report making recommendations for immediate action.

View the full Interim Report.

Emerging themes

The Royal Commission has identified several overarching and interconnected themes that have come to characterise the hearings of the Royal Commission to date. Although the Royal Commission notes that it is 'at an early stage in its inquiry…', the themes identified by the Royal Commission in its Interim Report and outlined below will likely inform the future direction, future hearings, and the likely recommendations of the Royal Commission. 

• Choice and control: The Royal Commission has heard evidence of people with disability having limited autonomy and choice in their health care decisions, living circumstances, intimate relationships, care conditions and a lack of support in the education and justice system. The Interim Report observes that supported decision-making may be particularly useful in optimising choice and control for people with disability. While not proposing any tangible solutions, the Interim Reports notes that the Royal Commission will continue to examine the 'links between limits on choice and control and the violence, abuse, neglect and exploitation experienced by people with disability'.
• Attitudes towards disability: While recognising that attitudes can contribute to violence against, and abuse, neglect and exploitation of, people with disability, the Royal Commission noted the difficulty of establishing this link given the complexity around establishing a direct link between biased, prejudiced attitudes and harm caused to people with disability.
• Segregation and exclusion: The Royal Commission has heard evidence of historic and ongoing segregationist practices, including in the education, housing, recreation and employment sectors. The Interim Report acknowledges the immense impact and stigma that segregation and exclusion has inflicted on people with disabilities, and notes that the Royal Commission will continue to examine this important issue.
• Restrictive practices: The use of physical, chemical and mechanical restraints in education, residential, health and detention settings has been examined by the Royal Commission. The Interim Report flags that the Royal Commission will 'consider how the use of restrictive practices can be avoided, prevented or minimised, and if there are circumstances where they are required, what rules and safeguards should apply.' Importantly, the Royal Commission is using a definition of restrictive practices that extends beyond physical, chemical and mechanical restraint. The Royal Commission also considers psycho-social restraints (such as the use of power-control strategies), environment restraints (such as restricting a person's free access to all parts of their environment) and the use of consequence drive practices (the withdrawal of activities of items).
• Access to services and supports: Evidence detailing violence, abuse, neglect and exploitation from support workers, including sexual assault inflicted upon people with disabilities, has been heard by the Royal Commission. While support workers and support services often play a valuable role for people with disability, the Interim Report notes this issue will be subject to further consideration by the Royal Commission, especially in relation to barriers to accessing services and supports.
• Advocacy and representation: It is clear from the Interim Report that the Royal Commission considers advocacy and representation services critical for quelling abuse violence against, and abuse, neglect and exploitation of, people with disability. The Interim Report does observe that 'We have also heard that existing advocacy services are under-funded'.
• Oversight and complaints: The Royal Commission has heard from people with disability that their complaints against disability service providers have been minimised, ignored or have gone unreported. Some people with disabilities have also been punished for making complaints about the care or services they have received.
• Data: Reporting and data availability on the violence, abuse, neglect and exploitation experienced by people with disability across all sectors and settings is inadequate. Remedying data gaps and identifying areas where the lack of data hinders policy development will be a future focus areas for the Royal Commission.

Community Engagement and Private Sessions

The Royal Commission undertook extensive community engagement across a range of matters. Private sessions were also conducted, enabling people with disability to share their experiences in a private setting. The Royal Commission outlined some emerging themes that have arisen from community forums:

• the need for better regulation, oversight, transparency and accountability;
• the barriers to self-advocacy;
• control, autonomy, disempowerment, and discrimination;
• the role and recognition of families; and
• issues with the accessibility and responsiveness of service systems.

The community forums provide another perspective on the emerging themes from the work of the Royal Commission and its likely future direction. The Interim Report captures some of the frustrations being communicated at community forums, particularly around the lack of oversight and regulation of service providers and barriers to self-advocacy that are encountered by participants. Human rights issues feature strongly, and people with disability have communicated their frustrations to the Royal Commission that international human rights for people with disability have not been implemented in domestic legislation and do not flow through to policies and practices.

Key issues

In addition to the emerging themes identified in the Interim Report, several key issues are also identified. These key issues have been identified through the course of the Royal Commissions' public hearings, submissions, community engagement, private sessions, research and responses to issues papers and relate to issues across systems, jurisdictions and services. A concise summary of these issues is provided below.

• Education: The Interim report details how people with disability have experienced violence, abuse and neglect across the education system. Access to education, violence and abuse and even restrictive practices in education settings have been considered by the Royal Commission. These issues will be subject to ongoing consideration by the Royal Commission, including specifically what structural changes are required to the existing education systems across Australia to better protect students with disability from violence, abuse, neglect and exploitation.
• Homes and living: The Interim Report notes that people with disability are particularly vulnerable in their own home. The Royal Commission has recognised that people with disability have endured unexplained injuries and commonly experience neglect in supported accommodation. A lack of viable housing options and other attitudinal barriers for people with disability will be the subject of further consideration by the Royal Commission.
• Relationships: Domestic violence perpetrated against people with disabilities has been a focus for the Royal Commission, with the Interim Report noting an increasing prevalence of this issue. Child removal and relinquishment also features as a significant issues in the disability sector.
• Health care: Evidence of difficulty in obtaining access to quality healthcare and accessibility issues once healthcare has been procured, such as communication barriers, as well as involuntary treatment have been heard by the Royal Commission.
• Community participation: The exclusion of people with disabilities from community participation, especially during the recent COVID-19 pandemic has been highlighted in the Interim Report. Creating greater opportunities for social inclusion and address attitudinal barriers to achieving this will be key considerations for the Royal Commission in future hearings.
  
  'People with disability experience high levels of poverty and socio-economic disadvantage, and are more likely to experience financial hardship and unemployment, with lower incomes and higher costs associated with living with disability.'
• Economic participation: Issues concerning the difficulty of obtaining employment, violence and abuse committed against people with disability in the workplace, has been considered before the Royal Commission. The Interim Report recognised wage inequity and employment segregation are also factors impeding the ability of people with disability to attain socio-economic equality.
• The NDIS: The Royal Commission has considered at a very preliminary stage issues relating to the NDIS, which the Interim Report notes include difficulty in accessing and navigating available services under the NDIS and significant confusion about whether NDIS providers are able to continue to support a person with disability when they are in the care of a health service. Future hearings of the Royal Commission specifically addressing the NDIS will no doubt touch on this issue.
• The justice system: A lack of awareness of the legal rights of people with disability, difficulty in navigating an unfamiliar system, and a failure of those working in the justice system to recognise the need to respond appropriately to people with a disability, are some of the issues the Interim Report recognises in relation to people with disability in confronting the justice system. These issues will be the subject of further consideration of the Royal Commission in later hearings.
• First Nations people: The Royal Commission devotes a specific chapter to the experience of First Nations people with disability, and identifies that a high proportion of First Nations people live with disabilities, and are exposed to a greater extent to violence, abuse, neglect and exploitation. In its continued investigations, the Royal Commission will specifically consider the experience of First Nations people with disability.

The Royal Commission's future direction

The Royal Commission has flagged that there is 'still much [work] to do'. The emerging themes and issues outlined in the Interim Report represent a confounding set of issues confronting people with disabilities. Despite the Interim Report not proposing any specific recommendations, we expect that many of the future hearings and recommendations of the Royal Commission will seek to resolve the structural issues identified in the Interim Report. 

The Honourable Ronald Sackville AO QC, Chair, has requested an extension to the final report from 29 April 2022 to September 2023. The Royal Commission has flagged that it will 'present an evidence-based argument for change, with practical and implementable recommendations for reform that will seek to precent and better protect people with disability from violence, abuse, neglect and exploitation'.

The themes and issues outlined in the Interim Report should not be considered exhaustive, nor an indication of the extent of the issues the Royal Commission will consider. In light of the requested extension of the final reporting date for the Royal Commission, we expect that the themes and issues identified thus far will remain, but that additional issues will likely arise throughout the course the next three years.