George Disney, Yi Yang, Peter Summers, Alexandra Devine, Helen Dickinson, and Anne M Kavanagh were very careful when they wrote their February MJA article. Their statistics were solid. They could have screamed, ‘Here’s proof, the NDIS is wealthy people’s welfare’. Instead, they let the data speak for itself.

Their analysis of statistics from 2016 to 2022 found that eligibility rates were lower for women and girls, older applicants, and people from socio-economically disadvantaged areas, and especially for those with physical, psychosocial, or unclassified disabilities.

While plan sizes and spending among eligible participants showed smaller disparities, the study highlighted persistent social inequalities in access to the scheme. Their findings suggested an urgent need to review NDIS eligibility processes to ensure fairer outcomes.

And what happened? The result has been exactly what you would expect. Sotto voce murmuring, careful nodding and displays of concern, but absolutely no desire to tackle the central issue.

Why? Because of cost. And there’s no pushback either. The marginalised people who are missing out are exactly that: disempowered and excluded from our national conversation.

Two letters in this month’s MJA revisit the study. Both are concerned with an even more marginalised sub-group; people in regional and remote areas. They point out that the disparity faced by those living in ‘real Australia’ - the outback and First Nations people - face massive obstacles before they can become eligible for the NDIS.

Sadly, the sort of scheme that works well for an articulate, empowered and wealthy person living in the city (capable of spelling out their specialised needs and accessing individualised services to meet them) doesn’t - and probably can’t - ever exist in the bush.

The requirements are different and need re-examination from the ground up.

The answer may be either to make people more capable of accessing the NDIS; or it may be to reconstitute foundational supports that embed disability services.

Whatever option is chosen, something must be done. Nodding and tut-tutting has gone on for far too long. The letters demonstrate there’s no doubt about the problem or the solution: what’s missing is the political will to address the issue.