Submission to Inquiry: The National Disability Insurance Scheme Amendment
(Securing the NDIS for Future Generations) Bill 2026
I am a physiotherapist working with children, primarily in early intervention, with more than 20 years’ experience in the disability sector. Over that time, I have worked in public sector disability services, as a university educator, in community settings, within an NDIS Early Childhood Early Intervention partner role, and within a mobile private practice providing community-based therapy supports to children and families.
I have worked in the disability sector before the NDIS, during its implementation, and throughout its evolution to the present day. I have therefore observed the disability sector from multiple perspectives across both the pre-NDIS and NDIS environments.
I am deeply concerned by the cumulative impact of the proposed changes within the NDIS Amendment (Securing the NDIS for Future Generations) Bill and the broader direction of recent reforms to the Scheme. In my view, many of the proposed changes appear inconsistent with the foundational principles that originally underpinned the NDIS, including valuing the individual and considering their needs holistically, family-centred practice, capacity building, flexibility, and choice and control.
While I acknowledge the need for the Scheme to remain financially sustainable, I am concerned that the current reforms risk prioritising administrative and financial controls over long-term participant outcomes, early intervention, and genuine inclusion and participation.
Functional Capacity (proposed s 9B)
One of my strongest concerns relates to the proposed definition of functional capacity, including wording that assesses a person’s ability to undertake activities “without assistance from other people, assistive technology or modifications” and “in a context that excludes, as far as possible, the impact of personal and environmental circumstances”.
As a children’s physiotherapist, one of the foundational principles of paediatric practice and early intervention is that children do not exist in isolation, but within the context of their family, community, relationships, and environment. This can be said even for typically developing children, without any additional support needs. It is difficult to understand how it would be possible and why it would be meaningful to assess a child’s functional capacity while excluding personal and environmental circumstances.
In my daily practice, these factors are central to understanding a child’s participation, safety, routines, support needs, and developmental trajectory. For many children, assistive technology, environmental modification, supervision, co-regulation, and adult support are not optional extras but essential for daily function and quality of life.
To me, the proposed definition is not consistent with the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). This is an internationally recognised framework that forms the baseline of my everyday disability practice. The ICF explicitly recognises environmental factors as a core determinant of functioning and participation.
I am concerned the proposed functional capacity definition risks creating artificial assessments that do not reflect the real-world experience of disability or the practical supports required for children and families to safely and happily participate in everyday life.
Early Intervention and Treatment Burden
I also have concerns regarding proposed changes relating to permanence, eligibility, and expectations that participants exhaust available treatment options before being considered eligible for support.
Access to treatments is affected by many factors, including geography, cost, public waiting lists, and family capacity. Requiring families to pursue every possible treatment pathway before accessing disability supports risks creating inequity, particularly for rural and lower socioeconomic families.
I am especially concerned for children, where timely early intervention is often critical to long-term developmental outcomes. Delays in accessing supports during key developmental windows may have significant down-stream effects, resulting in reduced movement, communication, independence, learning and educational outcomes. This could potentially increase future support needs rather than reduce them.
Increasing Pressure on Families
The proposed reforms also appear to increase expectations on families to provide therapeutic implementation, supervision, behavioural support, exercise programs, transport, care coordination, and daily disability-related care.
In my practice, I often use a coaching model. I am not there to “do something” to the child but to work together with their family to implement therapeutic strategies that fit into their daily life and routines. This could be teaching a child with physical disability learning to climb into the car by themselves, to increase their autonomy and reduce risk of injury to their parent. I am the coach and the parent/caregiver is the do-er. Even if I visited weekly (which is rare), one practice session per week would not be enough for the child to learn. The parent is helping them to practice every time they get in and out of the car. These types of interventions are effective, powerful and backed by research, but they do place a significant physical and emotional demand on a caregiver for a task that most children learn through experience, much earlier and without great effort.
In my daily work I encounter many families of children with disability who are already functioning under extremely high levels of stress and caregiving demand, often while balancing employment pressures, financial strain, fragmented services, and sometimes their own mental health challenges. In many cases, parents are already providing substantial unpaid support that far exceeds what would typically be expected within the general community. I am wary of any proposed changes that would increase pressure further still.
I am also concerned that reducing supports during critical developmental periods may result in poorer long-term outcomes for children, greater family burnout, increased pressure on education and health systems, and ultimately higher long term societal costs.
Ministerial Discretion and Reduced Safeguards (including proposed ss 332EA and 32K)
I am concerned by the breadth of ministerial discretionary powers proposed within the Bill, including powers relating to funding caps, support limitations, and restrictions that may apply to classes or categories of participants under proposed sections 332EA and 32K.
As an experienced clinician, I find it difficult to identify circumstances in which broad cohort-based funding caps would provide a more accurate or equitable outcome than assessment of an individual’s actual support needs. Disability support needs are naturally variable, even within the same diagnostic group, and I believe these powers risk undermining one of the fundamental principles upon which the NDIS was established: that supports should be tailored to the individual. In my work with children and families, I observe daily that disability and functional needs are complex, overlapping, highly individual and sometimes unpredictable. A strong, equitable and just NDIS must be underpinned by legislation that responds flexibly to genuine participant needs.
Review and Reassessment (including proposed s 48A)
I am concerned about proposed changes relating to reassessments and review pathways, including those contained in proposed section 48A.
Children’s circumstances can change rapidly due to growth, developmental transitions, educational transitions, changing behavioural presentations, equipment requirements, family circumstances, or progression of underlying conditions. The timelines for these changes can be highly variable between children. It is important that the Scheme remains responsive to significant changes in participant circumstances and that participants can access timely reassessments to meet these changing needs. Please consider the interaction between plan length and need for reassessment. If a child’s plan is 12 months long or even longer, predicting what they will need and how they will change across long periods is sometimes difficult. Timely
and easily accessible plan reassessments are critical to ensure children get what they need, when they need it to live fun and fulfilling lives.
Provider Sustainability and Sector Confidence
The NDIS was established as an insurance-based scheme and actively encouraged development of a responsive provider market. In response, many experienced clinicians moved from public and NGO sectors into private practice to help meet demand and provide flexible, local, community-based, participant-centred services.
Over recent years, however, the sector has experienced significant cumulative pressure, including pricing reductions, increasing administrative burden, shifting interpretations of eligibility and reasonable and necessary supports, uncertainty regarding Foundational Supports, and ongoing policy instability.
There is growing concern across the sector that the principles that originally underpinned the NDIS are being progressively eroded. For me, this Bill has intensified those concerns.
Conclusion
I urge the Committee to carefully consider not only the individual provisions of the Bill, but also their combined impact on participants, families, providers, and the long term integrity of the NDIS. While Scheme sustainability is important, this cannot be achieved simply by restricting access, reducing flexibility, or shifting responsibility onto families and other service systems, like health or education. Long-term sustainability also depends on maintaining trust in the NDIS, preserving a skilled disability workforce, supporting families to continue caring roles safely, and ensuring people with disability can meaningfully participate in their communities and live their lives with dignity, independence and joy.
Thank you for the opportunity to provide this submission.
Reference
World Health Organization. (2001). International Classification of Functioning,
Disability and Health (ICF). Geneva: World Health Organization.