Submission to NDIS Amendment (Getting the NDI back on Track No. 1) Bill 2024

By Emilia Baduy Physiotherapist AHPRA reg number: PHY0002652613

I currently practice as a physiotherapist with special neuro physiotherapy focus in 2 practices in Sydney. I arrived in Australia in 2015 and whilst working towards recognition of my prior qualification and experience as a physiotherapist in Argentina, I worked as a support worker. I worked for registered agencies and self managed participants delivering complex personal care as well as social and employment support.

In my experience, both as a support worker and as a physiotherapist, it has been when NDIS participants have had genuine, informed and supported choice and control over the support they receive and its delivery that the highest quality services and outcomes are achieved.

In my practice as a physiotherapist I have seen many instances where NDIS funds are wasted. I have seen many cases where Allied health professionals such as physiotherapists, OTs and EPs have prescribed or over-prescribed inappropriate NDIS funded equipment. The equipment, in my judgment and from reports by the participants themselves, was recommended with little consultation with the participant, and with little regard for whether it was specifically appropriate to them. Very expensive equipment sits unused in their homes and after consultation with them we often find simpler and less expensive solutions that are more appropriate.

I have also seen suppliers of equipment charge more for equipment because it is being paid for using NDIS funds and participants being charged more for services because they are NDI funded.

I believe that in the current system it is too easy for allied health professionals and businesses to waste funds in such ways and I feel that the current Bill has the potential to further entrench this waste.

Definition of Supports

In particular my concern is with the removal of the principle of reasonable and necessary supports and its replacement with a definition of supports.

In my experience, supports that are most effective are ones that clearly align with a person’s goals and are often innovative in nature. If supports are overly proscribed by systems that cannot possibly take into account the vast array of impairments and the complexity of their disabling effects, it removes the power from the treating specialist and the participant

Page Heading

This page contains information about innovative approaches in providing non-disability-specific supports through NDIS funding.

Itself to be innovative, explore non-disability specific supports and find often simpler and cheaper more appropriate and effective solutions to achieve good outcomes. For example:

• For one patient with MS who has poor temperature regulation who presents with pain and lack of function due to muscular contraction the NDIS funds might be best spent on an air conditioner so that the person has access to appropriate heating and cooling.
• This, in conjunction with regular massage and a well-targeted program of flexibility and strength exercises, may be the most effective and cheapest way to achieve good outcomes in pain management and cramping that is exacerbated by cold living spaces.
• For another patient with spinal cord injury, who has prior strong knowledge and interest in the practice of yoga, the most effective way to build an effective pain management, flexibility and strength program is to work alongside her yoga teacher in a supportive role to develop a program and have her integrated back into mainstream yoga classes.
• For someone recovering from a stroke, who has a passion for skiing, support for him to return to the sport by developing the strength and flexibility program at his local gym might be the best way to motivate him to fully engage with a program of recovery and get faster, longer-lasting results.

A definition of support does not encourage a physiotherapist to consider options ‘outside the box’ and does nothing to curb over-prescription. It also risks further locking participants into only being able to use disability specific services leaving them more vulnerable to being overcharged.

Recommendations

Reasonable and necessary remain the guiding principle of deeming appropriate supports

If a definition of support is deemed necessary then this definition is broad so that innovation is not hampered or discouraged by current and future governments

That allied health professionals with appropriate specialist experience are engaged to develop these definitions for each particular class of participants.

No machine-readable text was extracted from this page.