Submission by
THE ASSOCIATION OF PROFESSIONALS AUSTRALIA
January 2026
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Introduction
Professionals Australia welcomes the opportunity to make a submission to the Joint Committee of Public Accounts and Audit Inquiry into the Administration of the National Disability Insurance Scheme (NDIS) (Parliament of Australia, 2026).
Professionals Australia represents allied health professionals across Australia, including clinicians delivering therapeutic, behavioural, developmental, psychosocial, and capacity building supports funded through the NDIS (National Disability Insurance Agency, 2023). Our members work in sole practice, small and medium practices, not-for-profit organisations, and larger provider services. They interact daily with National Disability Insurance Agency (NDIA) planners, payment systems, compliance mechanisms, and regulatory frameworks, and they experience firsthand the consequences of administrative decisions made within the Scheme (Australian Institute of Health and Welfare, 2022; Australian Neurodivergent Parents Association, 2026; Sweeney, 2026).
This submission addresses how administrative design, governance arrangements, compliance practices, and decision-making architecture within the NDIA and the NDIS Quality and Safeguards Commission are undermining participant access to clinically necessary supports, continuity and quality of care, allied health provider viability, workforce stability and retention, and the long-term financial sustainability of the Scheme (Australian National Audit Office, 2024; Australian National Audit Office, 2025a; Australian National Audit Office, 2025b; Australian National Audit Office, 2025c; Australian National Audit Office, 2025d; Australian National Audit Office, 2026).
This submission is informed by informed by extensive member experience, analysis of Auditor-General reports identified by the Committee, and matters raised in other submissions to this Inquiry, including those of Mark Sweeney and the Australian Neurodivergent Parents Association (ANPA), both of which raise serious and credible concerns about systemic administrative, legal, and governance risk (Australian Neurodivergent Parents Association, 2026; Sweeney, 2026).
The NDIS as a Statutory Scheme and the Central Legal Risk
The NDIS is not a discretionary welfare program. It is a statutory scheme that creates individual legal entitlements for eligible participants under the National Disability Insurance Scheme Act 2013 (Cth) (Australian Government, 2013). Those entitlements are framed by the objects and principles of the Act and must be given effect in substance, not merely in form (Australian Government, 2013).
Administrative efficiency, cost containment objectives, workforce pressures, or digital system design cannot lawfully displace the obligation to make individualised, evidence-based decisions that reflect the statutory criteria. Where administrative frameworks prioritise throughput, standardisation, or budget outcomes over statutory fidelity, the Scheme is undermined in practice even if it appears intact on paper (Australian Neurodivergent Parents Association, 2026).
Australian administrative law draws a clear distinction between the lawful use of policy to guide discretion and the unlawful substitution of statutory judgment. Where decision-makers rely on assumptions,
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templates, system defaults, or automated logic instead of forming the required state of statutory satisfaction on the evidence before them, decisions are unlawful regardless of intent or good faith (Amato v Commonwealth of Australia [2019] FCA 1133).
These principles were articulated clearly in Amato v Commonwealth of Australia (Robodebt), where the Federal Court confirmed that statutory powers conditioned on satisfaction must be exercised in fact and cannot be inferred from averages, assumptions, or automated processes (Amato v Commonwealth of Australia [2019] FCA 1133).
More recently, in National Disability Insurance Agency v Sutherland [2026] FCA 3, the Court reaffirmed that statutory questions under the NDIS Act must be answered by reference to the Act’s text, context, and purpose, informed by its objects and principles (National Disability Insurance Agency v Sutherland [2026] FCA 3).
The administrative practices described in this submission directly engage these principles and expose the Commonwealth to material legal, financial, and governance risk (Australian Neurodivergent Parents Association, 2026).
Objects, Principles, and the Role of Allied Health Evidence
The objects and principles of the NDIS Act require that participants are supported to pursue their goals and aspirations, participate in social and economic life, and receive reasonable and necessary supports tailored to their individual circumstances (Australian Government, 2013).
These principles are legally operative and must guide every administrative decision made under the Scheme (Australian Government, 2013).
Allied health professionals are central to giving practical effect to these principles. Clinical assessments, functional capacity evaluations, risk assessments, behavioural analyses, and longitudinal therapeutic evidence are the primary means by which decision-makers can understand the real-world impact of disability on a participant’s daily life (Australian Institute of Health and Welfare, 2022; World Health Organization, 2011).
This evidence is inherently individualised and cannot be meaningfully reduced to generic categories without loss of substance (Australian Neurodivergent Parents Association, 2026).
Professionals Australia submits that the increasing reliance on standardised decision templates, constrained digital systems, and policy shortcuts risks transforming a legislatively individualised scheme into one that operates on inferred norms rather than statutory entitlements (Australian Neurodivergent Parents Association, 2026).
Allied health professionals report that detailed clinical reports are frequently summarised into narrow system fields, stripped of nuance, and displaced by generic assertions about “mainstream supports” (Australian Neurodivergent Parents Association, 2026).
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The ANPA submission demonstrates how this manifests at scale, with repeated assertions that participants’ needs are “more appropriately met by mainstream supports” without identifying those supports or evidencing their availability, accessibility, or suitability (Australian Neurodivergent Parents Association, 2026).
While ANPA focuses on children, allied health professionals report similar reasoning being applied across adult cohorts, particularly in relation to psychosocial disability, neurodivergence, and complex physical conditions (Australian Neurodivergent Parents Association, 2026).
From mid-2026, the NDIA intends to implement centralised participant assessments conducted by in-house assessors using structured tools, including the I-CAN v6 and the Participant Eligibility and Complexity Questionnaire (PECQ). The stated purpose of this reform is to standardise assessments, reduce reliance on external provider reports, and improve administrative efficiency.
While framed as promoting consistency and fairness, centralised assessments fundamentally alter the role of allied health professionals in planning and budgeting decisions. Treating clinicians possess longitudinal, context-specific knowledge of participants’ functional capacity, risks, and progress. Replacing this evidence with one-off structured interviews risks undermining the NDIS Act’s requirement for individualised, evidence-based decision-making grounded in real-world functional impact
Professionals Australia submits that centralised assessments cannot lawfully substitute for clinical evidence where statutory criteria require consideration of individual circumstances. Any system that diminishes the weight of treating-provider evidence increases the risk of unlawful decision-making and systemic under- funding of necessary supports.
Financial Sustainability, Compliance, and False Economies
Professionals Australia is deeply concerned that current approaches to compliance and cost containment are creating illusory short-term savings while generating substantial downstream liability and systemic instability (Australian National Audit Office, 2025d; Australian Neurodivergent Parents Association, 2026).
Evidence before the Committee demonstrates that payment integrity actions are not consistently risk-based, proportionate, or time-limited, that prolonged payment holds and manual claim reviews are imposed without findings of fraud, and that compliant allied health providers experience severe cash-flow disruption as a direct result of NDIA administrative actions (Australian National Audit Office, 2025d; Sweeney, 2026).
One documented case involved a registered allied health provider operating seven sites and supporting approximately 500 NDIS participants. Despite passing an NDIS Commission audit, the provider experienced repeated payment reviews over a six-month period, with more than $600,000 in claims withheld. After repeated attempts to resolve the matter with the NDIA and the NDIS Commission, the provider became insolvent and ceased operations in December 2025. No fraud findings were made and no infringement notices were issued (Sweeney, 2026).
This outcome disrupted participant care, displaced a skilled workforce, and increased pressure on remaining providers. Participants were required to seek new clinicians, repeat assessments, and navigate service gaps.
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These costs are not captured in financial statements, yet they directly undermine the Scheme’s sustainability (Australian National Audit Office, 2024; Sweeney, 2026).
As ANPA demonstrates in relation to plan erosion, apparent fiscal restraint achieved through legally unstable administrative practices creates contingent liabilities through litigation, retrospective remediation, adverse audit findings, and unbudgeted administrative costs. From a sustainability perspective, lawful administration is itself a financial safeguard (Australian Neurodivergent Parents Association, 2026).
Pricing Caps, Workforce Supply, and the False Assumption of Elasticity
Professionals Australia submits that current NDIS pricing arrangements, including pricing caps and indexation mechanisms, are contributing materially to workforce instability and service withdrawal, particularly among allied health professionals operating in small practices and regional or outer-metropolitan areas (National Disability Insurance Agency, 2023; Australian Institute of Health and Welfare, 2022).
NDIS pricing caps operate on the implicit assumption that allied health labour supply is elastic and that providers can absorb rising costs without reducing service availability. This assumption is increasingly untenable (Organisation for Economic Co-operation and Development, 2021).
Allied health professionals face rising costs associated with wages, professional indemnity insurance, clinical supervision, mandatory professional development, rent, information technology systems, and compliance obligations. Where pricing caps fail to reflect these costs, providers are forced to either reduce service delivery, cross-subsidise NDIS work with private income, or exit the Scheme altogether (Organisation for Economic Co-operation and Development, 2021; National Disability Insurance Agency, 2023).
Evidence before the Committee demonstrates that pricing constraints interact with administrative burden in compounding ways. When clinicians are required to undertake unpaid administrative work to respond to plan reviews, internal reviews, audits, or compliance actions, the effective hourly rate for NDIS work is reduced further. This disproportionately affects early-career clinicians and sole practitioners, who are least able to absorb unrecoverable time (Sweeney, 2026).
Professionals Australia submits that pricing caps which do not reflect the true cost of delivering clinically appropriate supports undermine workforce supply and distort the market (Productivity Commission, 2019).
These effects are not theoretical. Members report reducing the number of NDIS participants they see, limiting services to lower-complexity clients, or declining to accept new referrals altogether. In thin markets, the result is not cost containment but service scarcity (Independent Advisory Council to the NDIS, 2022; Australian Neurodivergent Parents Association, 2026).
From a sustainability perspective, under-pricing allied health services increases long-term costs by delaying intervention, reducing functional gains, and increasing downstream demand for higher cost supports (Productivity Commission, 2019; Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2023).
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Indexation Lag, Cost Shock, and Structural Erosion of Allied Health
Capacity
While pricing caps are a significant constraint on allied health service delivery, they do not operate in isolation. Professionals Australia submits that indexation arrangements within the NDIS compound pricing pressure by failing to reflect the real and immediate cost increases faced by allied health providers (National Disability Insurance Agency, 2023).
Indexation applied to NDIS pricing has consistently lagged behind increases in wages, professional indemnity insurance premiums, rent, clinical supervision costs, and regulatory compliance expenses. For allied health practices employing staff under modern awards or enterprise agreements, wage increases are fixed and unavoidable. When pricing adjustments do not keep pace with these increases, providers are required to absorb the gap, reduce service delivery, or exit the Scheme (Organisation for Economic Co-operation and Development, 2021).
This structural erosion is particularly damaging because it operates incrementally. Providers may remain technically viable in the short term while quietly reducing their NDIS caseload, limiting services to lower- complexity participants, or ceasing to take new referrals. These changes do not immediately appear in headline expenditure figures but materially reduce system capacity over time (Sweeney, 2026).
Professionals Australia submits that indexation lag creates predictable market failure. Pricing arrangements that fail to reflect actual cost structures undermine workforce supply and distort incentives in ways that are inconsistent with long-term Scheme sustainability (Productivity Commission, 2019).
Workforce Stability, Retention, and the Hidden Costs of Administrative
Instability
The long-term sustainability of the NDIS depends on the retention of a skilled allied health workforce capable of delivering complex, individualised supports. Professionals Australia submits that current administrative practices within the NDIA are actively undermining workforce stability and accelerating attrition from the disability sector (Australian National Audit Office, 2025d; Sweeney, 2026).
Allied health professionals report that administrative instability, including unpredictable payment processes, opaque compliance actions, and repeated plan reductions, is a primary driver of burnout and exit from the Scheme. These pressures are particularly acute for early-career clinicians and sole practitioners, who lack the financial buffers required to absorb prolonged payment delays or repeated unpaid administrative work (Sweeney, 2026).
When experienced clinicians leave the NDIS, participants lose continuity of care and are often forced to re- enter assessment and onboarding processes with new providers. This duplication of assessments and therapy planning increases Scheme expenditure while reducing care quality. In some cases, participants disengage entirely due to exhaustion or loss of trust, leading to deterioration in functional capacity and
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increased long-term support needs (Australian Institute of Health and Welfare, 2022; Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2023).
Workforce retention must therefore be recognised as a core sustainability issue. Administrative practices that destabilise the workforce increase costs over time and undermine the objectives of the Scheme (Productivity Commission, 2019).
Impact on Supervision, Training, and Long-Term Workforce Supply
The sustainability of the NDIS workforce depends on the capacity of current practitioners to train, supervise, and mentor the next generation of allied health professionals. Professionals Australia submits that pricing constraints and administrative burden are eroding this capacity (Organisation for Economic Co-operation and Development, 2021).
Senior clinicians report reduced willingness to provide supervision when time spent on mentoring, documentation, and risk management is unpaid or financially penalised. Early-career clinicians struggle to access supported entry into NDIS work, particularly in regional and high-complexity settings (Organisation for Economic Co-operation and Development, 2021; Sweeney, 2026).
This represents a significant long-term risk. Undermining training and supervision today will exacerbate workforce shortages tomorrow, increasing reliance on short-term or less experienced providers and driving higher long-term costs (Productivity Commission, 2019).
Travel Time, Non-Face-to-Face Work, and Access Inequity
Travel time and non-face-to-face work are critical components of allied health service delivery under the NDIS, particularly for participants with complex needs, limited mobility, or who live outside major metropolitan centres (Australian Institute of Health and Welfare, 2022).
Professionals Australia submits that current pricing and administrative settings inadequately recognise the realities of delivering safe, ethical, and effective care (National Disability Insurance Agency, 2023).
Allied health professionals routinely undertake travel to participants’ homes, schools, workplaces, and community settings. Travel is not incidental to service delivery. It is often essential to delivering supports in environments where participants function in daily life. However, restrictions on billable travel time, inconsistent interpretation of pricing rules, and retrospective scrutiny of travel claims create uncertainty and financial risk for providers (National Disability Insurance Agency, 2023).
Members report that fear of compliance action has led some providers to limit travel-based services, particularly in regional, outer-suburban, and peri-urban areas. This disproportionately affects participants with limited transport options, families without capacity to attend clinics, and communities already experiencing workforce shortages (Australian Institute of Health and Welfare, 2022).
Similarly, non-face-to-face work such as report writing, care coordination, collaboration with families and schools, and risk management is essential to quality outcomes. Where pricing structures or administrative
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practices discourage this work, clinicians are forced to choose between unpaid labour and reduced care quality. Neither outcome is sustainable (Sweeney, 2026).
Professionals Australia submits that access inequity arising from travel and non-face-to-face pricing constraints directly undermines the NDIS’s objectives and increases long-term costs through poorer outcomes and service disengagement (Productivity Commission, 2019; Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2023).
Deaf participants who rely on Auslan and other interpreting services experience acute access inequity under current NDIS administrative and pricing arrangements. Auslan and Deaf interpreters deliver services funded through a mix of NDIA-managed, plan-managed, support coordination, and self-managed arrangements. Many interpreters operate as sole traders and are not required to be registered providers, particularly where services are delivered under plan-managed or self-managed plans.
The classification of interpreting supports within the NDIS is complex and poorly understood at the administrative level. Translating and interpreting services sit within the Core Supports category under “Consumables”, alongside a wide range of unrelated supports. Critically, “communication support” delivered by disability support workers is not the same as professional interpreting, yet the lack of administrative clarity has resulted in unqualified or uncertified practitioners delivering interpreting services under interpreting line items
Allied health and interpreter members report that scarcity of NAATI-certified interpreters has led to widespread substitution by bilingual support workers or unqualified providers, often without appropriate professional indemnity insurance. This undermines government policy requiring the use of qualified interpreters and directly disadvantages Deaf participants by compromising accuracy, confidentiality, and safety
Although interpreters are not subject to formal NDIS pricing caps, members report the existence of de facto system-based caps. NDIA payment systems have rejected claims above specific hourly values due to system limitations, despite those limits not being published or intended as price controls. This creates uncertainty, discourages interpreter participation, and undermines transparent market functioning
Recent changes to NDIS plan funding release schedules further exacerbate access risk for Deaf participants. Quarterly release of plan funds can result in situations where emergent interpreting needs, such as medical or legal events, cannot be met because funds are temporarily unavailable. Providers are then forced to choose between refusing service, delivering services without payment, billing participants privately, or delaying invoicing until funds refresh. Each option creates ethical, legal, or financial risk and undermines the integrity of the Scheme
Professionals Australia submits that the failure to clearly distinguish between interpreting, translation, and generic communication support at the NDIA administrative level represents a serious access, equity, and governance failure. It results in inappropriate service substitution, unsafe practice, and inequitable outcomes for Deaf participants, particularly in thin markets where interpreter availability is already limited.
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Telehealth Substitution and the Risk of Administratively Driven Care
Models
Telehealth is an important and valuable modality within the NDIS when used appropriately (Australian Institute of Health and Welfare, 2022). However, Professionals Australia submits that telehealth is increasingly treated as a default or preferred substitute for in-person allied health services, driven by administrative and cost considerations rather than clinical appropriateness.
Members report implicit and explicit pressure to utilise telehealth in circumstances where in-person engagement is necessary to deliver effective care, including for participants with cognitive impairment, complex behavioural needs, sensory processing differences, or unsafe home environments. In such cases, telehealth is not a clinically equivalent alternative and may result in poorer outcomes or increased risk (Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2023).
Substituting lower-cost service modes without individualised clinical justification undermines the NDIS Act’s requirement for reasonable and necessary supports tailored to individual circumstances and risks unlawful decision-making where mode of delivery is determined by administrative preference rather than participant need (Australian Government, 2013).
Professionals Australia submits that telehealth must remain a clinically determined option, not an efficiency- driven default, and that administrative settings should not incentivise inappropriate substitution.
NDIA Performance, Operating Costs, and Financial Controls
Concerns raised by Professionals Australia align closely with matters identified in multiple Auditor- General reports that the Committee has identified as central to this Inquiry.
Auditor-General Report No. 22 (2024–25) highlights the importance of robust internal controls and reliable financial reporting across Commonwealth entities. In the NDIS context, weaknesses in financial systems and controls manifest operationally through delayed payments, manual workarounds, inconsistent reconciliation processes, and poor visibility of financial risk.
Auditor-General Report No. 39 (2024–25) identifies deficiencies in key financial controls of major entities. Evidence before this Inquiry indicates that NDIA financial control weaknesses have directly contributed to prolonged payment holds and provider insolvency, even where no non-compliance is ultimately identified.
Auditor-General Report No. 25 (2024–25) finds that Commonwealth entities continue to struggle to produce meaningful, reliable performance information. NDIA performance reporting remains heavily focused on throughput and internal activity rather than outcomes such as participant experience, service continuity, provider exit, or workforce impacts.
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These deficiencies create a significant assurance gap. Without reliable performance and financial data that reflects real-world consequences, neither the NDIA Board nor Parliament can meaningfully assess whether administrative practices are achieving the Scheme’s objectives or embedding systemic risk.
Data Quality, Average Cost Metrics, and Legal Risk
Professionals Australia submits that increasing reliance on average cost metrics and benchmarking within the NDIS creates both clinical and legal risk.
Allied health professionals report participants being compared to statistical averages that bear little relationship to individual functional need. This approach risks replicating the flawed reasoning criticised by the Federal Court in Robodebt, where averages were substituted for individual assessment.
From a governance perspective, the misuse of aggregate data undermines the reliability of performance reporting and increases exposure to legal challenge.
Centralised assessments also intensify legal and governance risks associated with reliance on standardised tools and average cost metrics. Structured interviews conducted by NDIA assessors are inherently limited in their capacity to capture complexity, deterioration, episodic disability, or cumulative functional impact over time.
Evidence indicates that such tools are being used to inform budget setting and support allocations, increasing the likelihood that participants will be benchmarked against inferred norms rather than assessed on their individual needs. This approach closely mirrors the defects identified by the Federal Court in Robodebt, where statistical averages were unlawfully substituted for individual assessment.
Professionals Australia submits that centralised assessments materially increase the Commonwealth’s exposure to legal challenge by embedding system-level constraints that are inconsistent with the statutory requirement to form individual satisfaction based on evidence.
Thin Markets, Regional Viability, and Administrative Amplification of
Scarcity
Thin markets are a persistent and well-documented challenge within the NDIS. Professionals Australia submits that current administrative and pricing settings are actively amplifying market thinness rather than mitigating it.
In regional and remote areas, allied health services are often delivered by a small number of practitioners covering large geographic catchments. These clinicians face higher travel costs, longer
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non-billable time, limited peer support, and difficulty accessing supervision and professional development. When combined with pricing caps that do not account for these realities, the financial viability of regional practice becomes precarious.
Administrative instability further compounds this risk. Payment delays, retrospective compliance reviews, and opaque decision-making processes have a disproportionate impact in thin markets, where the loss of even one provider can eliminate local service availability entirely. Participants may be forced to travel long distances, rely on telehealth where inappropriate, or go without supports altogether.
Professionals Australia submits that market stewardship requires more than monitoring provider numbers. It requires administrative and pricing settings that actively support workforce retention in areas of scarcity. Failure to do so shifts costs to families, state services, and crisis systems, undermining both sustainability and equity.
NDIS Administration and Disproportionate Impacts on First Nations
Participants
Professionals Australia submits that the administrative, pricing, and governance failures identified throughout this submission have a disproportionate and compounding impact on First Nations participants. These impacts are not incidental. They arise from the interaction between NDIS administrative design and the social, geographic, cultural, and historical contexts in which many First Nations participants live.
First Nations participants are more likely to live in regional, remote, and very remote areas where allied health markets are thin, workforce supply is limited, and service delivery requires significant travel, relationship-building, and non-face-to-face work. In these contexts, the assumptions underpinning NDIS pricing, compliance, and decision-making frameworks frequently do not hold. Pricing caps that fail to reflect travel time, cultural engagement, and coordination demands render service delivery financially unviable. Administrative scrutiny of travel and non-face-to-face claims disproportionately affects the very services on which First Nations participants rely.
Allied health professionals working with First Nations participants consistently report that culturally safe care requires time, continuity, and trust. This includes time spent engaging with families, Elders, Aboriginal Community Controlled Organisations, and local services. Much of this work occurs outside direct face-to-face sessions but is essential to achieving functional outcomes and participant safety. Where pricing and administrative settings discourage or fail to recognise this work, clinicians are forced to choose between providing culturally appropriate care and maintaining financial viability.
Administrative instability within the NDIS further exacerbates these challenges. Payment delays, retrospective compliance reviews, and opaque decision-making processes disproportionately affect
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services operating in First Nations communities, where providers often operate on narrow margins and have limited capacity to absorb financial shocks. The loss of even a single allied health provider in a remote or regional area can eliminate local service access entirely, forcing participants to rely on fly-in, fly-out services or to disengage from supports altogether.
Decision-making practices that rely on standardised templates and generic reasoning have particularly harmful consequences for First Nations participants. Assertions that participant needs can be met through “mainstream services” often fail to acknowledge that such services may be geographically inaccessible, culturally unsafe, or effectively unavailable. Where decision-makers do not engage meaningfully with evidence about cultural context, community infrastructure, or historical barriers to access, decisions risk being unlawful as well as ineffective.
Professionals Australia submits that this pattern raises serious concerns about fettering of discretion and failure to give genuine consideration to relevant matters, particularly where First Nations participants’ circumstances differ materially from assumed norms. These risks are amplified when internal review processes replicate the same constrained reasoning and fail to correct error.
Plan volatility and repeated reassessment requirements also have a disproportionate impact on First Nations participants. Continuity of care is essential in contexts where trust in government systems has been eroded by historical and ongoing experiences of harm. Frequent plan changes, reductions, or delays disrupt therapeutic relationships and reinforce mistrust, leading some participants to disengage from the Scheme entirely. From both a human and fiscal perspective, disengagement represents a failure of the Scheme’s objectives.
Compliance frameworks that rely on blunt tools such as payment holds and retrospective reviews also create particular risks in First Nations contexts. Providers delivering culturally safe services are often small, community-connected practices without the administrative infrastructure of large corporate providers. Disruptive compliance actions can destabilise these services rapidly, undermining local capacity and community trust. Where compliance frameworks fail to differentiate between professional, community-based providers and higher-risk actors, they inadvertently penalise the very services the Scheme relies upon to reach First Nations participants.
Workforce sustainability issues are especially acute. Allied health professionals working with First Nations participants frequently report higher emotional labour, travel demands, and professional isolation. When combined with pricing constraints, administrative burden, and moral injury arising from being unable to deliver necessary supports, these pressures drive workforce exit. This exacerbates existing inequities and undermines the Scheme’s capacity to meet its obligations to First Nations peoples.
Professionals Australia also notes that the exclusion of allied health professionals from system design and policy development has particular consequences for First Nations participants. Systems and templates designed without professional and community input frequently fail to capture
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cultural context, kinship structures, or community-based models of care. This increases the risk of inappropriate decisions and reduces the effectiveness of funded supports.
From a governance perspective, these issues raise serious concerns for parliamentary oversight. Apparent cost containment achieved through pricing caps, restricted travel, or reduced plan funding may mask increased costs borne by First Nations families, communities, and state-based systems. These costs often re-emerge in the form of crisis interventions, hospitalisations, child protection involvement, or justice system contact, undermining both Closing the Gap commitments and long-term fiscal sustainability.
Professionals Australia submits that addressing the disproportionate impact of NDIS administration on First Nations participants requires more than cultural awareness training. It requires administrative systems, pricing structures, and decision-making frameworks that are capable of recognising and responding to different contexts lawfully and effectively. This includes meaningful engagement with allied health professionals and First Nations communities in system design, transparent recognition of the true costs of service delivery, and governance arrangements that prioritise equity as a core measure of performance.
Failure to address these issues risks entrenching inequality within the Scheme and undermining confidence in its legitimacy among First Nations communities. From both an ethical and fiscal perspective, this represents a significant systemic risk that warrants close scrutiny by the Committee.
Decision-Making Architecture, System Design, and Procedural Fairness
Evidence before the Committee indicates that NDIA decision-makers operate within systems characterised by high-throughput expectations, constrained digital interfaces, reliance on predefined fields and templates, limited capacity for narrative reasoning, and automated or semi- automated correspondence.
While systematisation can promote consistency, it also carries a well-recognised administrative law risk, namely fettering of discretion. Where decision-makers are effectively required to select from predetermined options, discretion may exist in theory but not in practice.
Allied health professionals report that complex clinical evidence is frequently reduced to summaries incapable of capturing risk, deterioration, or longitudinal need. Reasons provided for decisions are often generic and formulaic, relying on stock phrases without meaningful engagement with the evidence. This undermines procedural fairness, prevents effective internal review, and increases the likelihood of external appeals.
Improving the quality of reasons and genuine engagement with evidence is not a procedural nicety. It is a practical mechanism for reducing error, litigation risk, and administrative cost.
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Centralised assessments further entrench the procedural fairness risks already present within NDIA decision-making architecture. NDIA assessors conducting structured interviews are not treating practitioners and lack ongoing therapeutic relationships with participants. The reduction of allied health input at the planning stage limits the participant’s ability to present comprehensive evidence and undermines the capacity for meaningful review.
Where decisions rely heavily on centrally administered tools, participants and providers report difficulty understanding how conclusions were reached or challenging them through internal review. This opacity undermines natural justice and increases reliance on external appeals, compounding administrative cost rather than reducing it
Clinical Risk, Duty of Care Exposure, and the Transfer of Liability to
Practitioners
Allied health professionals operating within the NDIS are bound by professional standards, statutory duties of care, and ethical obligations that exist independently of NDIA administrative decisions. Professionals Australia submits that current administrative practices are increasingly transferring clinical risk and liability onto practitioners while simultaneously constraining their capacity to mitigate that risk.
Members report frequent situations in which NDIA decisions reduce, delay, or deny supports that clinicians assess as necessary to manage risk, prevent deterioration, or maintain participant safety. Despite these constraints, practitioners remain professionally accountable for outcomes, including mandatory reporting obligations, coronial scrutiny, and potential regulatory action should harm occur.
This creates an untenable position for clinicians, who are required to choose between adhering to professional judgment and operating within administratively constrained plans. In some cases, clinicians report modifying treatment plans or limiting engagement with high-risk participants to reduce exposure, rather than because it is clinically appropriate.
Professionals Australia submits that this transfer of risk is neither acknowledged nor costed within the Scheme. It represents a hidden liability that undermines both participant safety and workforce retention and exposes the Commonwealth to downstream legal and reputational risk.
Administrative Burden, Unpaid Labour, and Hidden Cost Transfer
Administrative burden within the NDIS has reached a level where it constitutes a material transfer of cost from the NDIA to providers and clinicians. Allied health professionals report spending significant unpaid time responding to plan changes, providing repeated evidence, engaging in internal reviews, and navigating compliance processes.
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This unpaid labour is not captured in Scheme costings but represents a real economic cost borne by the workforce. Over time, it erodes the viability of NDIS practice, particularly for clinicians who do not have administrative staff or corporate infrastructure.
Professionals Australia submits that administrative burden functions as a form of indirect cost shifting. While it may reduce apparent NDIA expenditure in the short term, it increases burnout, workforce exit, and service scarcity, ultimately driving higher costs elsewhere in the system.
Reducing administrative burden through clearer decision-making, better reasons, and proportionate compliance would therefore deliver both workforce and fiscal benefits.
Internal Review, Natural Justice, and Compounding Error
Internal review is intended to operate as a safeguard against error. However, evidence before the Committee suggests that internal review processes frequently replicate the same constrained reasoning and assumptions as original decisions.
For allied health professionals, this results in repeated rejection of identical clinical evidence, limited or formulaic reasons that do not engage with professional assessments, erosion of confidence in review mechanisms, and escalation to external review or litigation.
As established in Amato, review cannot cure an unlawful original decision. Where systemic constraints persist at review stage, error is compounded rather than corrected, increasing legal exposure and administrative cost.
Plan Volatility, Repeated Reassessment, and the Disruption of
Therapeutic Integrity
Effective allied health intervention relies on continuity, consistency, and the ability to deliver interventions over time. Professionals Australia submits that increasing plan volatility within the NDIS is fundamentally undermining evidence-based care.
Members report frequent plan changes, shortened plan durations, and repeated reassessment requirements that disrupt therapeutic relationships and force clinicians to repeatedly justify the same interventions. This administrative churn diverts time away from service delivery and creates uncertainty for participants and providers alike.
From a clinical perspective, repeated disruption undermines treatment integrity and limits the capacity to achieve functional gains. From a system perspective, it increases administrative cost and reduces the return on investment in funded supports.
Professionals Australia submits that plan stability is not merely a participant experience issue. It is a critical determinant of clinical effectiveness and long-term cost containment.
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Compliance Frameworks, Professional Ethics, and Risk Differentiation
Auditor-General Report No. 48 (2024–25) found that the NDIA’s claimant compliance framework remains only partly effective, with weaknesses in prevention, detection, and risk differentiation.
Professionals Australia submits that compliance practices rely excessively on blunt tools such as payment holds and manual reviews, without adequately distinguishing between high-risk actors and compliant professional providers. Allied health practitioners are subject to professional registration requirements, codes of conduct, and ethical obligations. Administrative practices that systematically discount clinical evidence or incentivise the dilution of professional judgment place clinicians in ethically untenable positions and undermine professional integrity.
Risk-based regulation must differentiate between professional clinical judgment and exploitative behaviour. Failure to do so drives ethical practitioners out of the Scheme and undermines participant safety.
Inconsistent Interpretation of Rules and the Erosion of Administrative
Fairness
Allied health professionals consistently report material inconsistencies in how NDIA rules, pricing provisions, evidence requirements, and compliance expectations are interpreted and applied across regions and decision-makers.
Members describe situations in which practices deemed compliant in one context are retrospectively questioned in another, creating significant uncertainty and financial risk. This unpredictability makes sustainable practice planning difficult and discourages investment in the NDIS market.
Inconsistency also undermines administrative fairness and increases reliance on internal and external review mechanisms. Where outcomes depend more on who makes a decision than on the evidence submitted, confidence in the Scheme is eroded.
Professionals Australia submits that consistent interpretation is a core internal control issue and should be treated as such for governance and audit purposes.
NDIS Quality and Safeguards Commission, Market Stewardship, and
Intergovernmental Risk
Auditor-General Report No. 2 (2025–26) found that the NDIS Quality and Safeguards Commission was only partly effective in exercising its regulatory functions, including market oversight and information sharing.
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Evidence indicates that the vast majority of providers are unregistered, significant NDIS payments flow outside direct regulatory oversight, and there is no transparent framework to identify provider distress or mitigate unplanned service withdrawal.
A recurring feature of NDIA decision-making is the increasing reliance on assertions that participant needs should be met by mainstream systems, including state health, education, and community services. These assertions are frequently made without evidence that such services are available or capable of meeting disability-related needs. This creates intergovernmental cost shifting rather than genuine savings and undermines cooperative federalism.
Pricing, Regulation, and the Disconnect Between Policy and Practice
Professionals Australia submits that there is a growing disconnect between policy assumptions underpinning NDIS pricing and regulation and the lived reality of allied health practice. Pricing models appear to assume stable demand, predictable workflows, and low administrative friction. In practice, clinicians face fluctuating plans, repeated reassessment, and significant compliance uncertainty.
This disconnect undermines confidence in the Scheme and discourages long-term professional commitment. Members report advising students and early-career clinicians against entering NDIS work due to perceived instability and ethical tension between administrative requirements and client-centred practice.
From a governance perspective, this should concern the Committee. Workforce withdrawal driven by misaligned pricing and regulation represents a structural risk to Scheme sustainability that cannot be resolved through compliance enforcement alone.
Governance, Board Oversight, and Parliamentary Accountability
Auditor-General Report No. 41 (2024–25) examined the effectiveness of the NDIA Board. While aspects of governance were assessed as largely effective, evidence before the Committee raises serious questions about whether the Board has adequate visibility of systemic administrative law risk, escalating internal operating costs per participant, and provider market instability.
Effective governance requires assurance that administrative systems give genuine effect to statutory entitlements and that emerging risks are identified and addressed early. Parliamentary onsight is therefore critical to restoring confidence in the Scheme.
System Design Without Professional Input
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Professionals Australia submits that allied health professionals have limited formal input into the design of NDIA systems, templates, and compliance frameworks.
Systems developed without meaningful professional input frequently fail to reflect clinical workflows, leading to inefficiency, error, and increased administrative burden. This exclusion increases systemic risk and undermines confidence in governance arrangements.
Incorporating professional expertise into system design would improve efficiency, reduce error, and strengthen the Scheme’s resilience.
Why Pricing and Travel Settings Are a Parliamentary Oversight Issue
Professionals Australia submits that pricing, travel, and non-face-to-face work settings are not merely operational matters. They are governance issues squarely within the remit of this Committee.
Where pricing fails to reflect the real cost of service delivery, or administrative practices discourage lawful claiming, the Scheme’s financial statements may appear controlled while underlying service capacity erodes. This creates a misleading picture of sustainability and masks growing risk.
Parliamentary oversight is therefore essential to ensure that pricing and administrative settings support, rather than undermine, the workforce required to deliver the Scheme.
Moral Injury, Administrative Harm, and Workforce Exit
Beyond workload and financial pressure, allied health professionals increasingly report moral injury arising from repeated exposure to administrative decisions that conflict with professional judgment and participant need.
Members describe distress associated with being unable to deliver clinically necessary supports, having to repeatedly justify basic interventions, or witnessing harm resulting from administrative constraints. This moral injury accelerates workforce exit and is a significant, though often invisible, driver of attrition.
Professionals Australia submits that moral injury should be understood as a systemic risk to Scheme sustainability. Addressing it requires administrative practices that respect professional expertise and prioritise lawful, individualised decision-making.
Conclusion
Professionals Australia submits that the sustainability of the NDIS depends on lawful administration, transparent governance, and a stable allied health workforce.
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Administrative systems that undermine individualised decision-making, provider viability, or workforce retention place participants, clinicians, and the Commonwealth at serious risk. Apparent short-term savings achieved through legally unstable practices are illusory and will ultimately cost more.
Professionals Australia welcomes the Committee’s scrutiny and stands ready to assist further.
References
Australian Bureau of Statistics. (2023). National Aboriginal and Torres Strait Islander health survey 2022–23. Commonwealth of Australia.
Australian Government. (2013). National Disability Insurance Scheme Act 2013 (Cth).
Australian Government. (2020). National Agreement on Closing the Gap. Commonwealth of Australia.
Australian Government. (2023). NDIS review: Working together to deliver the NDIS. Commonwealth of Australia.
Australian Government Productivity Commission. (2011). Disability care and support (Productivity Commission Inquiry Report No. 54). Commonwealth of Australia.
Australian Institute of Health and Welfare. (2022). People with disability in Australia. AIHW.
Australian Institute of Health and Welfare. (2023). Aboriginal and Torres Strait Islander people with disability. AIHW.
Australian Institute of Health and Welfare. (2023). Australia’s Deaf and hard of hearing population. AIHW.
Australian National Audit Office. (2024). Audits of the financial statements of Australian Government entities for the period ended 30 June 2024 (Auditor-General Report No. 22 2024–25). Commonwealth of Australia.
Australian National Audit Office. (2024). Performance statements auditing in the Commonwealth: Outcomes from the 2023–24 audit program (Auditor-General Report No. 25 2024–25). Commonwealth of Australia.
Australian National Audit Office. (2025). Interim report on key financial controls of major entities (Auditor-General Report No. 39 2024–25). Commonwealth of Australia.
Australian National Audit Office. (2025). Effectiveness of the Board of the National Disability Insurance Agency (Auditor- General Report No. 41 2024–25). Commonwealth of Australia.
Australian National Audit Office. (2025). National Disability Insurance Agency’s management of claimant compliance with National Disability Insurance Scheme claim requirements (Auditor-General Report No. 48 2024–25). Commonwealth of Australia.
Australian National Audit Office. (2025). Effectiveness of the NDIS Quality and Safeguards Commission’s regulatory functions (Auditor-General Report No. 2 2025–26). Commonwealth of Australia.
Australian Neurodivergent Parents Association. (2026). Submission to the Inquiry into the administration of the National Disability Insurance Scheme. Joint Committee of Public Accounts and Audit.
Deaf Australia. (2020). Position statement on Auslan interpreting and access to services. Deaf Australia Inc.
152 Miller St, West Melbourne VIC 3003 | 1300 273 762 | info@ProfessionalsAustralia.org.au Page 19 of 21
Department of Social Services. (2019). Improving outcomes for Deaf and hard of hearing Australians. Commonwealth of Australia.
Department of the Prime Minister and Cabinet. (2023). Measuring outcomes under the National Agreement on Closing the Gap. Commonwealth of Australia.
Federal Court of Australia. (2019). Amato v Commonwealth of Australia [2019] FCA 1133.
Federal Court of Australia. (2026). National Disability Insurance Agency v Sutherland [2026] FCA 3.
Independent Advisory Council to the NDIS. (2022). Advice on thin markets and provider sustainability. National Disability Insurance Agency.
Mark Sweeney. (2026). Submission to the Inquiry into the administration of the National Disability Insurance Scheme. Joint Committee of Public Accounts and Audit.
National Aboriginal Community Controlled Health Organisation. (2021). Culturally safe health systems for Aboriginal and Torres Strait Islander peoples. NACCHO.
National Accreditation Authority for Translators and Interpreters. (2023). NAATI certification and standards for interpreters. NAATI.
National Disability Insurance Agency. (2023). NDIS pricing arrangements and price limits. NDIA.
National Disability Insurance Agency. (2023). Participant service guarantee. NDIA.
National Disability Insurance Agency. (2024). NDIS support catalogue and Core Supports classification. NDIA.
National Disability Insurance Agency. (2024). Provider payment assurance framework. NDIA.
National Disability Insurance Agency. (2024). NDIS quarterly report to disability ministers. NDIA.
NDIS Quality and Safeguards Commission. (2023). Regulating for quality and safety: Annual report. Commonwealth of Australia.
Organisation for Economic Co-operation and Development. (2021). Disability, work and inclusion in Australia. OECD Publishing.
Productivity Commission. (2019). Review of NDIS costs. Commonwealth of Australia.
Productivity Commission. (2023). Workforce challenges in disability services. Commonwealth of Australia.
Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. (2023). Final report. Commonwealth of Australia.
Senate Community Affairs References Committee. (2022). General issues around the implementation and performance of the NDIS. Parliament of Australia.
United Nations Committee on the Rights of Persons with Disabilities. (2017). Concluding observations on the combined second and third periodic reports of Australia. United Nations.
World Health Organization. (2011). World report on disability. WHO Press.
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