Response to Parliament on NDIS changes Protecting the NDIS for future generations Joan Ryan Ba App Sc OT. Email.
AHPRA No. OCC 1722237 Ph:
ABN 69 040 566 560 Postal:
Date. 1/6/2026 Until this budget the NDIS has been a game changer. I am an OT who graduated in 1986. I have worked continuously as an OT ever since. I love my work. OT has an area of expertise called Activities of Daily Living, and it is exactly what it claims to be. An OT aims to get someone with a disability to be able to have as much independence as possible in their day-to-day life. This is empowering to the person with the disability and an extremely satisfying job for all. In my time as an OT (40 years, this year), I have lived through so many funding schemes. Mostly we have to script to the funding and ask the Lion’s Club to make up the shortfall. We made ramps at 1:12 when the Australian standard is 1:14. We had to compromise. A lot. It seems such a shame that in these times of great advances in technology, we are still saying that independence is too expensive, living an ordinary life, too expensive, community access, too expensive. We can do better. Community access You do need to make budget decisions and cut to NDIS spending, but a 50% across the board changes to community access means that people can get up, showered, but not go out. It means that someone with a behaviour of concern might need to have support whether they are in the community or not. Nothing is that simple. The changes you have identified are random, poorly coordinated and have left therapists, participants and others working in the scheme scared for the next move. Plan review and unscheduled plan reviews The scheme needs an overhaul. The systems are not working. If a participant gets to a plan review and the planner decides they need more information before they can process one of the requests, they generally recommend that the participant go and get that info and then apply for a new Change of Circumstances review. That’s at least 3 months wait. Not many things can be added to a plan outside of the planning meeting or 5 working days beyond.
One of the changes planned by the bill is to reduce the number of mid-term plan reviews. At the same time, they are introducing most plans to run for a period of 5 years. How can someone with a deteriorating condition such as Multiple Sclerosis or Ehlers-Danlos syndrome predict the 5 year future? This is really happening, and I’d be happy to give examples. The OT functional assessment may be an expensive report, but it is comprehensive and describes each individual. The new form of assessment is undefined, not yet built, and not delivered by clinicians. The biggest concern is that it takes the person out of context, out of their environment. The assessor does not need to ask all the questions in the tool and the system to appeal is no longer independent. That is cheaper, but it’s not an improvement. In addition, everyone on the scheme is to be reassessed as to their eligibility. No, no, no. Baby, bathwater. We need a tool that’s fit for purpose and this one show little promise of that. You need to assess fairly and you need to assess a person in context, in their environment, within their family or supporting them leaving home or whatever step they are taking in life. Reasonable and Necessary. The changes in this area are very concerning. One point in particular is under value for money. Can this item, say a wheelchair, be provided more cheaply? Nearly always yes, but in my assessment, I have described why this more expensive one will be a better fit for this individual. A comparable item is only comparable if it delivers the same outcome. That’s important. The same outcome! This can be the difference between someone getting up, or their capacity to drive independently, to transfer in public toilets as just 2 examples of how a tailored solution can be the difference between living and existing. These 2 examples are from my caseload. They are real. Application process. When I used to submit an assistive technology report to some of the older schemes, they were always reviewed by their clinical team, 2 people max and they were approved or not. Simple. I have no idea why your process goes through several departments and takes 3 or more months. No one asks for a wheelchair unless they need it. They need it now, not in 3 or 4 months of approval and 2 more months with the supplier. That’s not fair, and not respectful of the person with the disability. Person centred. The NDIS needs to be person centred, the person with the disability. The scheme needs to be codesigned with these people who know disability better than anyone. Clinicians are also keen to input, so that the scheme can be lean and be the best fit for people with a disability.
Thriving kids and foundational supports Thriving kids is meant to be delivered shortly, yet no one ha any picture of what it looks like and where they will fit in the programme. Has this been thought through? I can’t have confidence. Other parts of the NDIS Unfortunately I do not have enough time to meet your deadline and include other areas of the scheme that need to be retained. It’s half an hour before the deadline tonight. There are things I would like to add about people with an invisible disability, our attitude towards informal support (taking our caregivers for granted), SDA, SIL. Please be careful. We run the risk of being institutional in our attitudes and our delivery of care to people with disabilities and that is so much worse than what we have now
Report prepared by Joan Ryan OT
NDIS Provider No.