Submission 1786

redacted: s47F - Personal privacy

redacted: s22(1)(a)(ii) - irrelevant material

redacted: s38 - Secrecy provisions

Thriving kids -

Occupational Therapist - Early Childhood Private Practice (Queensland)

I am an occupational therapist with 20 years’ experience working with children aged 0-8 years in Queensland. I operate a small, established private practice through Let’s Play Developmental Therapy, delivering early-intervention services from a fully equipped and evidence-based clinic.

Across my career, I have worked both independently and in larger practice settings, including previously employing other occupational therapists. My current model allows me to provide consistent, high-quality, relationship-based and capacity-building care to children, families and their educator providers.

My work primarily supports children in the early and pre-diagnosis stage - those who are developmentally vulnerable but do not yet meet eligibility thresholds for formal diagnosis or current funded programs.

In addition, I also provide services to children who are participants of the NDIS, including those with a diagnosis of Level 1 and 2 autism. This allows continuity of care as needs evolve over time, from early concerns through to more defined support requirements.

Importantly, the way I currently deliver services is strongly aligned with the stated intent and design of the Thriving Kids reforms. My practice already incorporates:

• early identification and functional support
• parent capacity building, including regular coaching and practical guidance
• collaboration with the education sector, including classroom strategies and participation in PSP and school planning processes
• intervention delivered in real-life contexts to support participation and development This is the model I, and many experienced private practitioners, have been delivering for years, including well before the introduction of the NDIS.

I support the intent of Thriving Kids to provide earlier, more accessible support for children and families. However, I am concerned that the current proposed design may unintentionally undermine the existing workforce already delivering this model of care.

Under Thriving Kids, children with mild to moderate or emerging needs will be directed into government-funded services delivered through selected contracted providers. Families who wish to access an independent clinician must do so without funding support. In effect, families are required to choose between funding and clinician choice.

Submission 1786

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In practice, referral pathways will reinforce this. Schools, early learning providers, GPs and child health services will naturally refer into Thriving Kids contracted providers, as these become the recognised and funded pathway. This creates a default system that redirects referrals away from independent practitioners - not based on quality or outcomes, but due to system design.

As a result, clinicians like myself - who are already delivering services consistent with the Thriving Kids model - may be excluded from the very system we align with and have been delivering for decades.

From a family perspective, this risks disrupting continuity of care and trusted therapeutic relationships. Families who have established progress with an independent clinician may be required to change providers in order to access funded support, at a critical developmental stage. This is inconsistent with relationship-based and trauma-informed early-intervention practice and may reduce engagement, effectiveness, and overall developmental outcomes.

There are also significant workforce implications. The current proposed model appears to favour large organisations and selected contract holders, while requiring experienced sole practitioners to:

• relinquish professional autonomy
• work under third-party organisational control
• accept allocated caseloads and locations
• and potentially take a substantial reduction in remuneration This is despite already demonstrating the capacity to independently deliver safe, effective, and efficient early-intervention services.

While this may not be intentional, the practical effect is a form of structural inequity, where access to funded work is tied to organisational scale rather than clinical experience or capability. This places long-standing, small private practices - including those established prior to the NDIS- at a significant disadvantage.

Independent private practitioners represent an important and vital component of the early-childhood system. They often provide flexibility, local responsiveness, and long-term continuity that larger service models can struggle to replicate. Many are embedded in their communities, collaborate closely with local schools and early learning settings, and retain senior clinical oversight within everyday practice.

The broader risk is that experienced senior clinicians will exit early childhood practice altogether. This would reduce access to senior clinical judgement, continuity of care, and

Submission 1786

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My concern is not about resisting refo1m. It is about ensuring that the refonn builds on existing strengths, rather than displacing them. A strong early-childhood system should include a mix of delive1y models, including experienced independent senior practitioners who are ah-eady embedded in their communities and delivering high-quality care. As a local highly experienced practitioner and small business owner, I am seeking reassurance that:

• the existing experienced private early-inte1vention workforce will be recognised as paii of the solution
• fainilies will retain meaningful choice in how they access support
• and funding and refe1rnl models will not unintentionally exclude experienced independent clinicians

Recommendations To suppo1i the success of Thriving Kids, I respectfully recommend that:

• mechanisms be established to allow independent, senior qualified private practitioners to deliver funded services without requiring employment by, or subcontracting through, lai·ge organisations
• referral pathways explicitly prese1ve family choice of provider, including independent clinicians who meet quality and safeguai·ding requirements
• workforce design recognise and retain experienced sole private practitioners, paiiiculai·ly those already delivering evidence-based eai·ly-inte1vention se1vices within community settings. Without this, there is a genuine risk that Thriving Kids may naITow the workforce it depends on, rather than strengthening it. I appreciate the work being unde1iaken to improve early suppo1i for children and farnilies, and I hope these insights contribute constrnctively to that process.

Kind Regai·ds,

Paediatric Occupational Therapist Let’s Play Developmental Therapy Ph: