Submission 1817 - Supplementary Submission

Submission to the Senate Community Affairs Committee

NDIS Future Generations Bill 2026

My name is . I am a Fellow of the Royal Australasian College of Surgeons and currently practise as a consultant general, endocrine and breast oncoplastic surgeon. I live in Sydney with my wife and our four sons, two of whom have profound and lifelong disabilities.

My sons live with cerebellar hypoplasia, a rare neurological condition, as well as Quadriplegic Ataxic Cerebral Palsy, autism level 2, severe intellectual disability, severe speech impairment, sensory processing difficulties and significant motor impairments. Their disabilities affect every aspect of daily life and require ongoing support, therapy, specialised equipment, supervision and advocacy.

I am writing to express my concerns regarding several aspects of the proposed NDIS Future Generations Bill 2026, particularly:

• The proposed functional capacity reassessments from 2028 onward,
• Tougher reassessment processes and reduced review rights,
• The proposed requirement that participants undertake all “appropriate treatments” before a disability is considered permanent, and
• The increased reliance on automated decision-making processes.

As both a parent and a medical specialist, I understand the importance of evidence-based development. However, I also understand the limitations of assessments, classifications and standardised processes when applied to complex human situations. Disability is highly individual. Even within the same diagnosis, people can have vastly different strengths, challenges and support requirements.

This is something I see every day in my own family. My two sons share the same rare neurological diagnosis, yet their disabilities affect them differently. Their support needs differ, their abilities differ, and the strategies that help one child are not always effective for the other. This experience makes me concerned about any system that relies heavily on broad disability categories, standardised assessments or automated processes to determine support needs.

One of my primary concerns relates to the proposed future functional capacity reassessments. Functional assessments can provide useful information, but they only capture a snapshot of a person’s circumstances at a particular point in time. They do not capture the years of therapy, intervention, support and family commitment that often sit behind a child’s progress.

Over many years, I have watched my sons achieve milestones that many families take for granted. Skills such as communication, mobility, emotional regulation and community participation have required enormous effort, persistence and support. These gains were not achieved because their disabilities improved or disappeared. They were achieved because appropriate supports were available. There is a real risk that progress may be interpreted as reduced need, when in fact it is often evidence that supports are working exactly as intended.

Submission 1817 - Supplementary Submission

I am also concerned about proposals that make reassessments more difficult to challenge while reducing review rights. As a medical practitioner, I believe it is important that significant decisions affecting a person’s future remain subject to appropriate review processes. No assessment process is perfect. No report can fully capture the reality of living with disability. Families must retain meaningful opportunities to seek review when decisions fail to accurately reflect their circumstances.

The proposed requirement that participants undertake all “appropriate treatments” before a disability can be considered permanent is another area of concern. As a medical professional, I believe this approach risks creating significant uncertainty for people living with rare and lifelong conditions.

My sons have cerebellar hypoplasia. There is currently no treatment that can reverse or cure their condition. Therapies are essential because they maximise function, communication, participation and quality of life. They are not curative. Families should not be placed in a position where they must continually prove they have exhausted every possible intervention in order to establish that a lifelong disability remains lifelong. This is particularly problematic for rare conditions where evidence is limited, treatment pathways are unclear and clinical opinions may differ.

I am equally concerned about increased reliance on automated decision-making. Throughout my medical career, I have learned that people rarely fit neatly into predetermined categories. Clinical practice often reminds us that individuals with the same diagnosis can have completely different experiences and outcomes. The same principle applies in disability. Decisions that affect a person’s independence, participation, education and quality of life should not be determined primarily by algorithms or automated systems. People deserve individual consideration, transparency and meaningful avenues of review.

I would also ask the Committee to consider the broader benefits that the NDIS provides to families and communities.

My work frequently requires me to spend time away from home providing specialist surgical services, including in regional and rural areas where workforce shortages are often significant. Like many parents of children with disability, my wife and I have developed a family structure that allows us to balance caring responsibilities with employment. The supports funded through the NDIS play a critical role in maintaining that balance.

As a medical practitioner, it is essential that I can focus fully on the patients under my care. That becomes significantly more difficult if I am concerned that my own children are not receiving the support they require or that my wife is carrying an unsustainable caring burden at home. The NDIS does not simply support the individual participant. It supports families. It enables parents to remain in the workforce, contribute to their communities and continue providing valuable services to others.

In my family’s case, the benefits extend well beyond the direct supports received by my sons. The stability created by those supports allows me to continue caring for patients, allows my wife to continue in her role as primary carer, and helps maintain the wellbeing of our entire family, including our other two children.

Submission 1817 - Supplementary Submission

The NDIS has had a profound positive impact on our family. It has enabled our sons to communicate, participate, learn and engage with the world in ways that may not otherwise have been possible. I understand the importance of ensuring the Scheme remains sustainable for future generations. However, sustainability should not come at the expense of individualised decision-making, procedural fairness and appropriate safeguards for people living with disability.

I respectfully ask the Committee to recommend that

• Functional assessments remain only one component of a broader individualised assessment process;
• Review and appeal rights remain meaningful and accessible;
• The proposed “all appropriate treatments” requirement be reconsidered, particularly for rare and lifelong conditions;
• Automated decision-making processes never replace genuine human assessment and oversight.

The decisions made through this legislation will have real consequences for real families. I ask the Committee to ensure that future reforms preserve the individualised and person-centred principles that have been fundamental to the success of the NDIS.

Thank you for considering my submission.

FRACS Consultant General, Endocrine & Breast Oncoplastic Surgeon