Placing Australians living with disability in positions of influence over service delivery can address sustained and invisible forms of negligence, a Royal Commission has been told.
Visual artist, writer, performer and wheelchair user Sam Petersen said it was "slow violence" when a person's needs were continually not met over time.
"In this case, it is done through a lack of knowledge and funding and these can feed off one another," Sam said in a pre-recorded video played to the Disability Royal Commission on Monday.
"A support worker isn't given enough training and time to do their job, so they're short with the client, then the client is upset, and this can be seen as bad behaviour.
"So the support worker spends less time engaging with the client."
Workers suffer from not enough training and support, lack of perceived job importance, and low wages leading to long hours, Sam said.
A five-day hearing of the Royal Commission that began in Brisbane on Monday is probing how service providers can prevent violence, abuse, neglect and exploitation.
Workforce issues were identified as a challenge for the sector in a National Disability Services 2022 report, Counsel Assisting Kate Eastman said in her opening.
"In terms of workforce, 2022 is probably most accurately described as going from bad to worse, recruitment and retention challenges remain across the board," she said.
Providers reported moderate or extreme difficulty recruiting allied health workers, difficulty identifying and recruiting suitably qualified disability support workers and noted that award rates do not reflect the complexity of the roles.
Ms Eastman quoted Productivity Commission findings that the disability care workforce has to double from 2014/15 levels to meet the demand created by the National Disability Insurance Scheme.
The figures came from a 2019 Department of Social Services report outlining the government's long term vision for a capable and adaptable NDIS workforce.
"This vision will require a mature market of diverse and strong providers delivering effective on the job capability development ... along with appropriate and accessible formal training pathways," Ms Eastman said.
It was here people with disability who required support workers had an important role to play, Sam said.
"There needs to be more training of support providers and support workers by well-paid people with disabilities who require support workers," Sam said.
"We need people with disabilities who require support workers to be supported to be in the highest roles of support providers."
