2.7.2026
To whom it may concern
I am an Accredited Practising Dietitian with 22 years of experience as a dietitian, working in private practise (for over 10 years) and specialise in nutritional care for people with disability. I am writing for the following amendments to A Bill for an Act to amend the National Disability Insurance Scheme Act 2013, and for related purposes. For the following schedules:
Schedule 3—Governance arrangements, Decision-making on pricing.
I would like an amendment to increase the Dietitians fees to $220 in line with the Government’s Aged care fees.
The current NDIS pricing cuts for Dietitian services of $15/hour over the last 2 years, $20 less than the Aged Care rate, puts many Accredited Practising Dietitians (APD’s) in the position of ceasing work in the disability sector and ceasing work as a Dietitian all together as business operation is no longer sustainable in the current economic climate and greatly increases the downstream economic costs of people with disability to our society.
Many dietitians have already left the NDIS, reduced their NDIS caseload including reducing home visit service, just like myself, and it is expected more will now follow with this pricing cut.
Allied health professionals, are all on the same award pay rate in health. We all have the same business expenses and cost just as much as each other. There is no need for pricing disparity in NDIS fees.
I earnt just over the tax-free threshold last financial year despite continuing to work on marketing, networking and having many other systems in place to increase my referrals and appointment bookings. I work at least 30 hours a week, juggling a young family, running my small business (in Dietetics not unlike many other Dietitians) and contributing to society with volunteer work in my personal time which is also related to my ‘paid dietetic’ work in my business to build networking and my client base, as such even my personal life is work-related. I feel like a workaholic. People are not spending money on their health as they used to due to the current economic climate and this
shows in my phone enquiries and business income. My overheads were only $10000, mostly tax and management fees/room rental for clinic which is the standard rate of 30 40% for most clinicians in allied health practises and GP practises.
Dietetics (with less than 10,000 APD’s) has one of the highest professional exiting rates shortly after university because there is no work available. Yet for an educated and intelligent country, we have high rates and increasing rates of diet-related chronic disease in Australia: 6.6% people have diabetes, two in five Australians will have mental condition over their life time (42%), and heart disease accounts for 25% deaths, just to name a small few. Hospital Dietitians and hospitals in general are already underfunded and stretched and they were relieved when their caseload of disability patients was offloaded to the private sector. People with disability are 2-3 times more likely to have a chronic and diet-related health condition and these conditions impact how much they can function and contribute to society, including getting paid work and not be a financial burden to society.
If NDIS Dietitians were classed as government workers, technically they are paid by the government (NDIS), this would be the highest pay cut for a university-trained professional who is required to do ongoing professional development in Australia’s history for workers, workers who provide the foundational service of nutrition to their clients, just like a Mum would nurture their child. We are not getting $15 less/hour in out pockets- this is more like $30/hour less in our pockets taking into account business overheads and personal tax i.e. at least $15-20,000 per year.
For a small profession which has huge economic impact, this is a small price for the government to pay for even greater economic rewards in the future. The cost of poor diets in Australia is $16.2 billion/year with this number to increase as chronic disease prevalence increases as is the current trend.
NDIS clients are COMPLEX and require 20+ hours of service per year. They are not as easy as seeing the average Medicare referral (20 minutes minimum cost at $63 for 5 rebatable consults a year) for a straight forward condition like diabetes, or aged care referral for weight gain due to poor appetite. Dietitians working in the disability sector deserve to be paid for their incredibly high skills and expertise and have increased salaries as they gain more experience, skills and expertise each year, just like the Health Award.
The work dietitians do changes and save lives. Food is a basic human right and without it our other needs cannot be met.
Dietitians are the most valuable and cost-effective intervention: We stabilise the foundations: energy, nourishment, hydration, gut function, metabolic health, sensory
safe eating, the ability to learn, regulate, move and engage in physio, OT, psychology, speech and daily living. Every other therapy: Speech therapy, Occupational therapy, psychology etc, will become less effective and more expensive in the longer term. Participants will need more OT hours because executive function collapses when basic needs aren’t met. More psychology because their brain is running on empty. More GP and hospital care because preventable issues and diseases escalate over time. Frr example 20% of 3 year olds in Australia are iron deficient which can cause potentially irreversible neurological developmental delay. For example, many teenagers I see with Autism and ADHD have likely been iron deficient (with other nutrient deficits for over a decade of their life, which has likely impacted their neurological development, limits their school participation and ability to prepare a simple food like toast, let alone cook a meal for themselves and find a skilled job, which they likely would have been able to do if they had dietetics in their NDIS plan for all their childhood years to work on with their complex needs to support their brain development. We help keep people out of crisis, in their homes, and in their communities.
With the NDIS allied health price cuts, people with disability are at greater risk of nutritional and associated functional decline, increased support needs, higher engagement with health and other government systems such as child protection and justice, children not meeting their developmental potential, and serious harm to disabled people. They will have a reduced ability to function to their full potential to be a contributing member of society i.e. be employable.
If the goal is sustainability, cutting the very therapy that prevents downstream cost is the opposite of reform. Nutrition is not optional. It is the platform that makes every other therapy possible and effective.
For every $1 invested in the NDIS, the Australian economy gains $2.25–$2.30 in return.
- The NDIS saves the health system and other government sectors billions every year.
- That’s $115 billion in economic activity generated by the NDIS annually.
- Unpaid carers save the government $78 billion every year.
- Employment gained by NDIS participants saves around $20 billion per year.
I would also like amendment to the travel fees for Dietitians to be 100% of travel time to participant’s home. Since the fees were reduced, I had greatly reduced my service of home visits as it is not worth my time to travel for such little pay.
When I worked for ADHC (Ageing Disability and Home Care) and NSW and Queensland Health, my wage was increased as per the award rates and I was paid for all my time to travel to see patient’s in their home. Since the government has offloaded this work to the private sector, they expect university qualified Health Professionals who work in the most complex medical conditions requiring the provision of the most complex and variable type of care not be paid for their increasing experience or for their time doing a task required of them (because the person with disability cannot come to clinic) for work, which in most cases involves using their personal car. This is not right, people with disability deserve to have their therapy supports paid appropriately for their time and to provide specialist experience and expertise for the care they need to meet their goals and optimise function and their ability to contribute to society.
Schedule 1
Part 3—Strengthen link between an impairment and need for support
I would like NDIS planners allocating funding to be more qualified in understanding different types of disabilities and allocate funding as per the allied health professionals’ recommendation, especially as Allied health professionals we abide by professional registration with a code of conduct and are required to uphold and advocate for best practise care.
I have written a number of NDIS reports and my request for increased funding for NDIS participants for allied health services due to their changing needs including funding for food for medical purposes (aka oral nutrition support or nutrition supplements) such as in the case of Huntington’s Disease (which is a progressive neuromuscular condition, requiring increased supports over time, just like many people with disability) denied after previously been approved.
My view is that my reports were simply did not read, funding was blankly denied or reduced on a number of occasions, and on one occasion, they did not quote my most recent report with the updated information and terminology in line with what is now ‘accepted’, even though in my report I explained that the participant’s disability increased their nutrition needs and nutrition support (their nutrition support/food for medical purposes provides 40% of their needs as they are not able to consume this amount due to their disability) with multiple reasons provided.
Thank you,
Kind regards