Submission 1558
To the Community Affairs Legislation Committee,
I write as an Occupational Therapist based in South Australia, with experience across NDIS, DVA, workers’ compensation, and medicolegal funding streams. I am writing to express my serious concerns about the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026, and to support the Occupational Therapy Australia No OTs, No NDIS campaign.
PLAN REASSESSMENTS AND THE 20% AVERAGE INCREASE
My first concern relates to the part of the Bill that would restrict plan reassessments to exceptional circumstances.
I have recently supported two clients through plan reassessment. The average 20% budget increase cited in relation to this Bill does not reflect misuse of funds, rather it reflects severely underfunded plans that failed to capture people’s real needs at the time of planning.
The first client uses a wheelchair and has an acquired brain injury. His only weekend support is provided by his parents, who are both over 80 years old. He required support coordination to navigate his plan, which was entirely beyond his own capacity and that of his elderly parents. Without reassessment, he would have continued without adequate support, placing him and his parents at significant risk of hospitalisation and preventable harm.
The second client has severe arthritis with associated brain fog and limited technology skills. Her plan covered only minimal therapy, despite her needing extensive assistive technology assessments at the start of a new plan. She also required support coordination to help her manage her supports effectively. Without reassessment, she would simply have gone without, putting her at risk of falls and serious injury.
In both cases, I provided substantial assistance to navigate the reassessment process. These clients do not have the capacity to do this independently. If unscheduled reassessment is restricted to exceptional circumstances, people in these situations will go without appropriate support, not because their needs are not real, but because the system has removed the mechanism to address them.
BLANKET REDUCTIONS TO COMMUNITY AND CAPACITY BUILDING SUPPORTS
My second concern relates to the proposed 10% reduction to capacity building daily activity supports and 50% reduction to social, civic and community participation supports.
These cuts do not reflect a person-centred or individualised approach to support. While there are certainly overfunded plans in the Scheme, those plans need to
Submission 1558
be reviewed individually not subjected to collective reduction. Applying blanket cuts while simultaneously restricting the ability to seek reassessment is particularly harmful and removes funding without providing any pathway to address the impact.
Community participation supports are not discretionary social outings. For my clients, they represent the ability to attend medical appointments, access Centrelink, manage banking, do grocery shopping, and maintain tenancy. Removing or reducing these supports does not save money, it just shifts cost to emergency services, hospitals, and the community sector.
FUNCTIONAL CAPACITY ASSESSMENT AND THE ROLE OF OCCUPATIONAL THERAPY My third concern relates to the part of the Bill that may allow support decisions to be shaped by rules, frameworks, or standardised tools rather than individualised assessment conducted by qualified professionals. Functional capacity assessment is not a self-report exercise. It requires skilled observational analysis to substantiate what a person can and cannot do in real-world contexts. In my clinical experience, people both over- and under-report their functional difficulties for a range of reasons. A client with an intellectual disability may have no insight into the extent of prompting they require to manage medication safely. A client who is not ready to confront the full impact of their condition may minimise their difficulties. Equally, a client who has been told their funding depends on demonstrating need may underestimate their actual capacity. None of these presentations can be accurately assessed through a tick-box tool or self- administered questionnaire. OT assessment triangulates self-report with clinical observation, functional task analysis, and environmental context to arrive at recommendations that are both clinically justified and proportionate to need. Replacing or subordinating this with algorithmic or rules-based decision-making will result in both over- and under-allocation of supports, neither of which serves participants or the scheme.
AUTOMATED DECISION-MAKING The Bill’s provisions allowing greater use of automated tools and systems in funding and eligibility decisions carry significant risk. Australia has already seen the consequences of automated government decision-making in the Robodebt scheme, where algorithmic processes produced incorrect and harmful outcomes at scale, with no adequate mechanism for individual review. Applying a similar approach to NDIS funding decisions in a population that already faces significant barriers to self-advocacy would be a serious step backwards. Automated tools cannot account for fluctuating conditions, environmental context, or the clinical nuance that distinguishes genuine need from apparent function. Human professional oversight must be a non-negotiable requirement at every decision point.
AFFORDABILITY OF TREATMENT AND ELIGIBILITY REQUIREMENTS
Submission 1558
My concerns also relate to the part of the Bill that may require people to demonstrate they have exhausted treatment options before accessing the Scheme. This creates a significant equity barrier. Many people with disability are not in paid employment or have reduced earning capacity precisely because of their disability. They do not have the financial means to privately fund the treatment pathway that would then be used to demonstrate eligibility. This is not a failure to engage with treatment; it is a consequence of the very circumstances that make NDS access necessary in the first place. Requiring proof of treatment exhaustion without accounting for affordability will systematically exclude some of the most vulnerable applicants, not because their needs are not real, but because they could not afford to prove them.
MINISTERIAL CONTROL OVER PRICING
My concerns also relate to the expansion of ministerial powers over NDIS pricing. This represents a direct conflict of interest. The Minister responsible for managing scheme expenditure would also be responsible for setting the rates paid to the professionals who deliver supports.
Occupational therapy rates under the NDIS have not meaningfully increased in almost eight years, despite significant cost of living pressures and inflation. This has driven experienced OTs out of the NDIS workforce or into sole practice structures that are increasingly financially precarious. If pricing decisions remain subject to ministerial control rather than independent determination, there is no structural safeguard against rates being suppressed further as a cost-containment measure.
Pricing must be determined by an independent body using transparent, evidence-based methodology that accounts for workforce sustainability. I am already seeing my colleagues leave the sector and our profession at an alarming rate due to financial constraints.
SCHEME SUSTAINABILITY AS A COLLABORATIVE APPROACH
I acknowledge that the NDS faces genuine sustainability pressures, and I do not oppose the goal of ensuring the scheme remains viable for future generations. However, the measures proposed in this Bill are not the right mechanism for achieving that. There are real opportunities to reduce scheme costs without cutting participant supports or undermining clinical oversight but they require genuine consultation with the allied health and disability sectors to identify them. For example, assistive technology pricing in the NDS is largely unregulated, resulting in significant market inflation. The Department of Veterans’ Affairs manages this effectively through scheduled equipment pricing, which caps costs while maintaining participant access to appropriate products. A similar approach in the NDS could deliver meaningful savings without reducing a single hour of therapy or community support. Reducing the administrative burden on treating professionals including the volume and prescriptiveness of reporting requirements would also free up clinical time and reduce provider costs, without
Submission 1558
Submission 1558