The number cruncher

Published: August 6, 2011  |  Source: theaustralian.com.au
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JOHN Walsh was an avid rugby league player and a star maths and physics student at the University of Sydney with dreams of carving out a career in the US as an astrophysicist.

But his life changed forever one chilly Saturday afternoon in July 1971 when he was barrelled into an unpadded wooden goalpost in the heat of a game. The collision severely fractured the 20-year-old’s spine at the neck level – not that Walsh understood it at the time. After being carried off the field, he rose to his feet, made his way home and, despite suffering pain all week, turned up the following week to play another match.

“It was just how things were back then”, Walsh, now 60, reflects today. “These days, you’d be taken to hospital for an X-ray and immobilised until the damage was healed. But then, no one realised the dangers. Yes, I was in a lot of pain, but that’s always the case after a footy game. The next week I ran on the field, I fell over – and that was it.”

In the blink of an eye, a dazzlingly bright university student with the world at his feet found himself a high-level quadriplegic, facing the rest of his life in a wheelchair. It was a tragedy, undoubtedly. But it was also the start of a chain of unlikely events that would lead Walsh to play a pivotal role in designing Australia’s proposed National Disability Insurance Scheme, or NDIS, which, if introduced this year, will change the course of many Australians’ lives for the better.

In recent years many influential public figures have begun promoting the idea of a universal, no-fault, national social insurance scheme to fund basic services for any Australian born with or acquiring a severe disability, replacing the current fragmented, underfunded state-based system. But Walsh has spent years doing the numbers, and has developed so compelling a case for the introduction of an NDIS that this multi-billion-dollar idea has gone, within a couple of years, from seemingly a pie-in-the-sky fantasy to a 2011 federal Cabinet agenda item. The Productivity Commission argued passionately for the introduction of an NDIS in a draft report released five months ago; Cabinet must respond by November.

In its first few years, an NDIS won’t come cheap – costing an additional $6 billion a year – but Walsh has shown how, through better early intervention services and increased productivity, it represents real economy in the long term, not to mention a better quality of life for tens of thousands of Australians.

Initially, Walsh’s quadriplegia looked like destroying his academic and future career dreams. “Uni campuses weren’t in the least wheelchair-friendly in those days and there were no personal care helpers or anything like that. My mum drove me to uni each morning, after which I’d have to spend the day in one room until she picked me up in the afternoon. The old boys’ association of my school, Christian Brothers Lewisham, raised funds to pay for home modifications and a wheelchair, but I couldn’t take notes at lectures or access the library, so after a while I just had to give up.”

After being forced to drop honours in 1972, Walsh received a stroke of good luck. “It just happened that my neurosurgeon played squash with a senior partner from an actuarial consulting firm and talked him into offering me a job, almost as a charitable gesture.” The one-time budding astrophysicist began work as a computer programmer, using sticks taped to his paralysed hands to laboriously code programs on to sheets of paper. He also started doing part-time actuarial studies by correspondence, which usually took five years to complete but, because of his physical limitations, took Walsh 10.

Sitting in the kitchen of his spacious, wheelchair-friendly house in a prosperous North Shore Sydney suburb where he lives with his wife, Michelle, and two of his three children, Walsh laughs when asked what motivated him to become an actuary. “Because that was where my neurosurgeon’s squash partner offered me a job. When I started, I didn’t even know what an actuary was.”

Walsh grins that “the real story, which hardly anyone knows”, is that after he graduated from school among the state’s top students, he was photographed for The Daily Telegraph “wearing nothing but a pair of footy shorts and a hard hat”, digging ditches for the Water Board to earn money before university began. “Three years later, after my accident, the Tele published a story headlined “Football Player Injured”, and Sir Frank [Packer] recognised my name, said ‘that’s the HSC kid’ and sent Mike Gibson to do a story. A couple of years after that, Mike recommended me as a subject for Channel 9’s This Is Your Life program. And that led to me being invited to talk to Rotary clubs around Sydney about what it was like to be disabled.” Stemming from these talks, Rotary funded an international study tour for Walsh to investigate disability support systems and statistics in Canada, the US and UK – a trip the young actuary accomplished despite the difficulties of travelling overseas in a wheelchair.

After returning to Australia, Walsh wrote a provocative paper for the Australian Institute of Actuaries stating that “basically, people didn’t know what they were talking about on the subject of severe disability”; an assertion he says drily was “not well received” by many colleagues. “Actuaries would look at the so-called ‘statistics’ when setting life insurance premiums, for instance, to assess individuals’ differing risks of acquiring a severe disability or dying prematurely from one. But there was so little real data, and what was available was largely anecdotal. I said, ‘Guys, we really have to improve this evidence base’.”

This paper led insurance companies and the Australian Institute of Health to sponsor Walsh from 1985 onwards to collect statistical data on the causes, incidence, prevalence and nature of disabilities. “I went around Australia talking to doctors, hospitals and disability organisations, collecting as much data as possible. There was a 1981 Bureau of Statistics survey of ‘handicapped persons’, but it wasn’t anywhere detailed enough for in-depth analysis. I advocated for the creation of a comprehensive National Registry of Disability – which never did happen. But if we do get an NDIS, a detailed national database will be one of its many benefits.”

Embarking on his pioneering work in a spare bedroom of his house, delving into the unknown with the aid only of a relatively primitive desktop computer, Walsh realised he had little choice but to focus on just one area of disability, and he selected spinal cord injuries, or SCI for short. “There are just six hospital SCI units in Australia, and I talked their directors into contributing data to the registry I established,” he says. The Australian Registry of Spinal Cord Injuries, as it’s now known, run by the National Injury Surveillance Unit, remains to this day the world’s only national, population-wide registry of its type.

“Once you get good data about the causes of disability, then you can put in place measures to prevent them,” Walsh explains. Such as, for instance, the X-rays that are now standard practice for spinal and head-injured footy players, preventing numerous incidents of paraplegia and quadriplegia. Just as importantly, Walsh instituted detailed follow-up interviews to investigate how SCI patients were going post-hospital with employment, personal relationships and health management. The picture that began to emerge for this group was, he says with considerable understatement, “not very good, at all. And that led me to start thinking there had to be a better support system. There just had to be.

“Gradually, I began to understand that the fundamental, crucial test of any disability system is its outcomes. It’s all about the quality of people’s lives, and their opportunities to participate in and contribute to society, whether they have been born with a disability or acquired one. Everyone has something to contribute, if just given the chance and the particular services and supports they need.”

Walsh went on to join the actuarial and accountancy firm PriceWaterhouseCoopers, where he rose to be a senior partner and from where, throughout the 1990s, he continued to think, research and write reports for governments on how to improve disability rehabilitation and support services. With the crucial, cabinet-level support of NSW Labor government minister John Della Bosca, Walsh designed and, in 2005, helped implement NSW’s gold-standard Lifetime Care & Support Scheme, providing high-quality, outcomes-focused services for people catastrophically injured in motor vehicle accidents, which has been funded through compulsory third-party motor vehicle insurance premiums. He also wrote a landmark report on the dire state of NSW’s disability system that was so compelling, it persuaded an initially reluctant NSW Treasury to invest several billion additional dollars from 2006 onwards to help address urgent unmet needs.

And all along, though he didn’t know it at the time, he was gathering together the facts, figures, evidence and ideas necessary to help others make the case, a few years later, for a radical proposal to bin Australia’s entire ramshackle, crisis-driven disability care and support system and replace it with a no-fault, national disability insurance safety net.

Little may have come of Walsh’s work were it not for several unlikely coincidences that wondrously occurred from 2007. First, Bruce Bonyhady, a Melbourne businessman and chairman of Victorian disability service provider Yooralla, was inspired by a conversation with former Labor deputy PM and social security minister Brian Howe to begin thinking about a national disability system based on insurance and investment principles. Second, the incoming Rudd government’s new parliamentary secretary for disabilities, Bill Shorten, took to his normally backwater job with a rare and energetic passion, becoming increasingly outspoken as he travelled around Australia talking to people with disabilities and their families. Third, Shorten reported to cabinet minister Jenny Macklin, who had once worked for Brian Howe and remained close to him. And fourth, Kevin Rudd’s wife, Therese Rein, happened to have a strong personal interest in disability issues, ¬having been inspired by a father left wheelchair-bound after a wartime injury to create a global business empire helping people with disabilities get jobs. The stars were aligning.

“As I began tentatively talking to people about my ideas,” Bonyhady says, “I was told I must contact a brilliant actuary in Sydney called John Walsh. I soon discovered that John not only had an encyclopedic knowledge of all the facts and figures, but brought insights from his own personal experience of disability that were invaluable.”

Bonyhady developed a proposal for an NDIS to present to the Rudd government’s 2020 Ideas Summit in early 2008 – later described by Rudd as one of the most exciting “big ideas” put forward. Alerted to the idea, Shorten established the Disability Investment Group, comprising leading Australian business and disability policy experts including Walsh and Bonyhady. After the group’s report strongly recommended detailed analysis of the NDIS idea, Rudd commissioned the Productivity Commission inquiry which, in a draft report released in February, also urged the introduction of an NDIS to replace a system it condemned as “underfunded, unfair, fragmented and inefficient”.

Recently awarded an AM, Walsh is a private person who rarely gives interviews. The personal cost of coping with quadriplegia, the physical pain and medical complications – all that he keeps to himself. “John is just so bright and authoritative, many people completely fail to realise how physically difficult and taxing it is for him to do what he does,” Bonyhady says. “He displays not a trace of self-pity, but just gets on with life in the most extraordinarily impressive way.

“And if not for that, if not for John, we would be nowhere close to where we are today; on the cusp of the introduction of a national insurance scheme that will bring crucial benefits to all Australians – because, whether people realise it or not, the simple fact is that disability can happen to anyone, any time.”

Sue O’Reilly
The Australian