Health Services Union submission regarding NDIS workforce sustainability (Provider advocacy) | External submission

Submission 323

Submission to the Inquiry into

National Disability Insurance

Scheme Amendment (Securing

the NDIS for Future Generations) Bill 2026

Senate Community Affairs (Legislation)

Committee

May 2026

Submission 323

About the HSU

The Health Services Union (HSU) is one of Australia’s fastest growing unions with over 115,500 members working in the health and community services sector across the country.

Our members work in aged care, disability services, community health, mental health, alcohol and other drugs services, private practices and hospitals. HSU members are health professionals (including allied health professionals), paramedics, scientists, disability support workers, aged care workers, nurses, technicians, doctors, medical librarians, clerical and administrative staff, managers, cleaners, security staff and other support staff and health workers.

You can find us at hsu.net.au

For questions regarding this submission, please contact:

Jackson Reynolds

National Policy and Campaigns Officer

Health Services Union

Submission 323

Introduction

The Health Services Union (HSU) welcomes the opportunity to provide this submission to the Senate

Standing Committee on Community Affairs regarding the National Disability Insurance Scheme

Amendment (Securing the NDIS for Future Generations) Bill 2026. Representing tens of thousands of disability support workers, allied health professionals, and administrative staff across Australia, the HSU has a profound interest in the structural integrity, safety, and long-term sustainability of the National Disability Insurance Scheme (NDIS). This submission draws on direct feedback from HSU branches across Australia, highlighting the severe anxiety felt by front-line staff.

We are concerned about the truncated consultation timeline for this Inquiry, and support the Joint Statement produced by the collective Disability Representative Organisations (DROs) highlighting that such major reforms should be approached with care and proper scrutiny, not rushed through with inadequate consideration of the impacts1.

The HSU cautiously welcomes those elements of the Bill that target rogue operators, tackle systemic fraud, and seek to reclaim regulatory accountability from a fractured market model. For too long, unscrupulous providers have extracted excessive profits on the taxpayer’s dime while suppressing worker wages and compromising participant safety.

However, the HSU expresses grave concerns regarding the massive scale of the projected funding cuts – totalling approximately $37.8 billion over the four-year forward estimates period – and the lack of direct support, professionalisation, or protection for the NDIS workforce within the primary legislative text. A comprehensive national worker registration framework or pilot is completely absent from Bill, which focuses exclusively on corporate/provider compliance and panel-manager restrictions.

It remains our firm view that the ‘sustainability’ of the NDIS is structurally inseparable from workforce stability, professionalisation, and fair working conditions. We remain concerned that any fiscal contraction of this scale inevitably creates downward pressure on the front-line workforce, resulting in shorter shifts, casualisation, and understaffing, which directly compromises the quality of care delivered to participants.

Summary of Recommendations

The Health Services Union recognises that the NDIS must be placed on a financially sustainable trajectory to secure its benefits for future generations. However, true sustainability cannot be achieved through blunt, unilateral budget cuts, the clinical narrowing of access criteria, or the erosion of workforce security. A sustainable scheme requires a highly valued, professional, and stable workforce.

To secure the NDIS for future generations while protecting both participants and the workers who support them, the HSU urges the Senate Standing Committee on Community Affairs to include the following recommendations in their Report to Government:

Recommendation 1: Subject Ministerial Powers to Parliamentary Oversight and Independent

Review

Amend the Bill to require that in making a determination on support categories, the Minister must have “regard to the safety of participants, and to the findings of an independent, expert panel”, and that the decision be made a disallowable instrument subject to active parliamentary scrutiny.

1 People With Disability Australia (PWDA). Media Statement from Australia’s Disability Representative Organisations. https://pwd.org.au/media-statement-from-australias-disability-representative-organisations/

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Recommendation 2: Amend the “All Appropriate Treatment” Test to Ensure Geographic Equity Amend the Bill to explicitly state that the availability, cost, and physical accessibility of “appropriate treatment” within a participant’s local geographical region must be taken into account when determining the permanence of an impairment. Regional and low-income Australians must not be denied access to the NDIS due to systemic specialist shortages outside their control.
Recommendation 3: Establish a Formal Safeguard Against Inter-Governmental Cost-Shifting Include a statutory requirement for a joint federal-state audit mechanism to monitor “boundary disputes.” This mechanism should trigger immediate mediation when a participant is denied NDIS support due to claims that the support is a “mainstream” responsibility, preventing participants from being caught in bureaucratic limbo.
Recommendation 4: Transition to an Independent Pricing Authority Instead of transferring final price-setting authority to the Minister, the Bill should place these powers under a completely independent, external pricing body (such as IHACPA); with a statutory mandate to set NDIS price limits based on the true cost of safe, high-quality, and award-compliant service delivery.
Recommendation 5: Implement a “Wage Pass-Through” Mechanism for Pricing Any legislative provision allowing for differentiated pricing must be legally bound to a “wage pass-through” mechanism. This ensures that any adjustments to price limits are transparently and directly applied to support worker wages, rather than being absorbed into provider margins.
Recommendation 6: Mandate Human-in-the-Loop for Automated Decisions Amend the Bill to explicitly prohibit the use of automated decision-making systems for any function that can result in the suspension, reduction, or revocation of a participant’s funding. Any such action must require an active, human-led clinical review to prevent catastrophic outcomes caused by algorithmic or data errors.
Recommendation 7: Establish a National Worker Registration Scheme Amend the Bill to mandate the creation of a comprehensive, individual National Worker Registration Scheme, linked to minimum qualifications, professional standards, and secure employment pathways. The Commonwealth should immediately fund a nationwide pilot of this scheme, using Victoria’s voluntary worker registration model as a template.
Recommendation 8: Formulate a Comprehensive, Co-Designed NDIS Workforce Plan The government must establish a formal, structured framework for ongoing co-design and consultation with the HSU and other relevant unions throughout the design, rollout, and evaluation of all commissioned services, registration frameworks, and planning tools. This must be backed by a fully funded NDIS Workforce Plan focused on secure employment, wage growth, and mandatory training. Schedule 1 – Access & Planning Measures Functional Capacity and Intrinsic Ability (Schedule 1, Part 1)

This section represents a fundamental shift in how disability is conceptualised under the NDIS. This section specifically excludes the impact of personal and environmental circumstances and instead requires that “intrinsic ability” be measured. Assessment of functional capacity must focus on a person’s overall ability to complete an activity as a whole, rather than on isolated tasks. By defining functional capacity purely in terms of this “intrinsic ability” and deliberately stripping out the impact

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of a participant’s personal and environmental circumstances (such as financial means, family dynamics, or living arrangements), the legislation adopts a highly medicalised, clinical focus.

The HSU is deeply concerned that this change will disadvantage vulnerable participants who lack strong advocacy, informal support networks, or financial resources. Disability does not exist in a vacuum; a person’s functional capacity is intrinsically linked to their environment. An assessment that ignores these real-world contexts risks under-funding those who face the compounding effects of socioeconomic disadvantage, housing instability, or geographic isolation.

Unscheduled Plan Reassessments (Schedule 1, Part 2)

The current administrative framework allows plan managers and support coordinators to submit unscheduled plan reassessment requests, sometimes without the direct knowledge or consent of the participant, driving up what Minister Butler has deemed ‘plan inflation’. This section, with the introduction of the new Subsection 48B, restricts the authority to request a plan reassessment exclusively to the participant, their plan nominee, or a child’s representative. We support this as a necessary measure to curb unauthorised provider claims and restore legitimacy to the Scheme.

However, we are concerned by the extension of the statutory decision-making period under Subsection 48(3) from 21 days to 90 days. This extensive delay has the potential to leave highly vulnerable participants trapped in outdated plan structures while experiencing rapid, genuine deteriorations in their functional capacity or family care circumstances, and leaves dedicated workers feeling distressed as they face a choice between being unable to provide supports or providing these supports unfunded and unpaid to ensure the participants do not go without.

Linking Impairment and Need for Support (Schedule 1, Part 3)

This section seeks to reverse various Federal Court and Administrative Review Tribunal decisions by introducing a highly rigid requirement that a funded support must arise “directly” from an impairment in relation to which the participant met the initial access criteria. We are concerned by this clinical narrowing, given that under this proposed law where multiple co-morbidities exist, the NDIA is required to artificially isolate the primary eligible impairment from secondary conditions, even when they interact dynamically.

For example, a participant who meets access via a physical impairment (such as limb difference) but also experiences severe mental illness would have their psychosocial support needs needs completely ignored in their plan budget, unless they had separately demonstrated functional impairment resulting from their mental ill health (under the new higher bar for NDIS Access), despite the clear compounding effect on their capacity to access education or employment. This direct causal requirement ignores the complex reality of disability, runs counter to the social model of disability, and will inevitably lead to under-funding and the deterioration of participant outcomes.

Support Determinations and Unilateral Spending Reductions (Schedule 1, Part 4)

Under the new Section 34A, the Minister is granted extraordinary power to unilaterally reduce funding for specified support categories across the board. The Bill places remarkably few constraints on this new power – Disability Services Consulting (DSC) described it as ‘Zeus-like’ in their analysis2 – the only limitation being that the Minister must “have regard” to the safety of participants. The government has already flagged that it is through these powers that the government will reduce social and community participation budget spending; though future Ministers could use the same power for wide reaching changes. The lack of limitation grants the minister almost unfettered power to make care decisions for participants without proper scrutiny or regulatory oversight and with fragrant disregard, under the current wording, for the daily experiences and circumstances of

2 Disability Services Consulting (DSC). Legislation deep-dive: Registration, fraud and governance. https://teamdsc.com.au/resources/legislation-deep-dive-registration-fraud-and-governance

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participants. Members hold serious concerns that a reduction in spending on one support category will have compounding effects on the care provided by workers under other categories. We are concerned that these reductions could place workers in a situation where they must choose between providing unpaid care or placing a participant in a potentially unsafe situation. The HSU stands with the disability community in opposing this power in its current, unchecked form. Unilateral, horizontal cuts of this nature disregard the individualised, needs-based foundation of the NDIS, run counter to principles of co-design intended to underpin the Scheme. We urge the government to ensure that any proposed support determination under Section 34 must be subject to an independent, publicly released human rights and participant safety impact assessment, and be made a disallowable instrument subject to active parliamentary scrutiny.

➢ Recommendation: Subject Ministerial Powers to Parliamentary Oversight and Independent

Review

Reasonable and Necessary (Schedule 1, Part 6)

The HSU supports the government’s intention to embed the concept of financial sustainability of the scheme into the objects of the Act, as this provides essential clarity and direction for the interpretation of the NDIS Act. However, the proposed amendments to the “reasonable and necessary” criteria – specifically regarding the treatment of informal supports – raise significant concerns regarding the equitable delivery of care.

The HSU is deeply concerned by the lack of consistency in how family and other informal supports are considered in this section. This inconsistency is compounded by the glaring contradiction within the broader legislative framework: while the Bill expects participants to rely heavily on informal, family, and community networks, it simultaneously and explicitly excludes a participant’s personal and environmental circumstances from the assessment of their functional capacity.

We are further concerned that by mandating that the NDIA consider the “desirability of supporting, maintaining and strengthening” informal supports, the Bill risks transforming voluntary care into a form of coerced, unpaid labour that the Scheme was originally designed to supplement rather than replace. The legislative mandate to avoid funding supports that are aimed at reducing the ‘burden’ on parents’ time, to improve household efficiency, or address parental preference, effectively offloads critical care responsibilities onto families, often without regard for caregiver burnout. It also completely neglects the fact that significant sections of the NDIS workforce are themselves carers or part of a support network in their own lives; and risks increasing worker burnout.

Permanence and “All Appropriate Treatment” (Schedule 1, Part 8)

This section introduces a highly restrictive test for determining the permanence of an impairment, requiring that a person undergo “all appropriate treatment” before gaining access to the Scheme. Presumably as an attempt to overrule Federal Court decisions that have interpreted the current legislative requirements that treatments are ‘available’ to mean what an individual could realistically access – which takes into consideration a person’s financial situation, geographic location, whether a disability itself can impact access to a treatment – this Bill explicitly states that treatment is considered appropriate regardless of whether a person’s individual circumstances, including financial means or geographical location, restrict them from accessing it.

This provision creates a severe, systemic geographic inequity. In regional, remote, and outer metropolitan communities, specialist waiting lists often stretch into years, and critical allied health treatments are completely unavailable. Under the proposed changes, a person living in regional

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Tasmania or remote Queensland who cannot access or afford a recommended specialist treatment will be deemed ineligible for the NDIS because they have not completed “all appropriate treatment”.

The HSU strongly opposes this provision, which effectively punishes regional and low-income Australians for the structural failures of the broader healthcare system.

➢ Recommendation: Amend the “All Appropriate Treatment” Test to Ensure Geographic Equity

Amend the Bill to explicitly state that the availability, cost, and physical accessibility of “appropriate treatment” within a participant’s local geographical region must be taken into account when determining the permanence of an impairment. Regional and low-income Australians must not be denied access to the NDIS due to systemic specialist shortages outside their control.

Eligibility and Mainstream Systems (Schedule 1, Part 9)

The exclusion of individuals from the NDIS if their needs can be met by alternative government service systems or compensation schemes (such as state-based workers’ compensation or motor vehicle accident insurance) risks triggering a wave of cost-shifting between the Commonwealth and state governments. HSU branches have already noted significant pressure on health and hospital settings, where NDIS discharge delays keep individuals in hospital beds unnecessarily.

Tightening eligibility based on the availability of other mainstream systems will exacerbate these boundary disputes, as state agencies and the NDIA engage in bureaucratic stand-offs over who is responsible for funding. This not only delays critical support for participants but also increases the fiscal burden on overstretched state-funded public hospital networks.

➢ Recommendation: Establish a Formal Safeguard Against Inter-Governmental Cost-Shifting

Include a statutory requirement for a joint federal-state audit mechanism to monitor “boundary disputes”. This mechanism should trigger immediate mediation when a participant is denied NDIS support due to claims that the support is a “mainstream” responsibility, preventing participants from being caught in bureaucratic limbo. Schedule 2 – Fraud & Integrity Measures Provider Registration (Schedule 2, Part 1)

This section amends the definition of an NDIS provider. It replaces the old, binary definition of an NDIS provider with legal architecture for the Graduated Risk-Proportionate Regulatory Model (e.g., advanced registration, general registration, and basic enrolment) based on the risk level of the delivered support. While the Explanatory Memorandum notes that the NDIS Provider and Worker Registration Taskforce advocated for a comprehensive, universal registration model – a position the HSU supports – the Government has elected to narrow the scope of these requirements, citing concerns regarding concurrent reform implementation.

The Government proposes a tiered, risk-based approach, prioritising mandatory registration for providers delivering ‘high-risk’ supports. Notably, the current definition of ‘high-risk’ remains unspecified. While the Memorandum (and statements by the Minister) indicates an intent to capture personal care, daily living assistance, and services delivered in closed or isolated settings, this lack of precision creates a significant regulatory vacuum.

The HSU strongly endorses the Government’s move to mandate registration for providers delivering Daily Activities and Personal Care. These supports represent the most intimate and high-risk interactions in a participant’s life; therefore, they should be the absolute baseline for mandatory, robust regulatory oversight. We view this as a necessary and long-overdue step to professionalise the sector and filter out the bad actors who have exploited current loopholes. By mandating

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registration in these critical settings, the Government creates the essential infrastructure required to support a qualified, registered, and professionalised workforce.

However, without a robust, transparent, and immediate definition that encompasses the full spectrum of high-risk service environments, the proposed reforms risk leaving vulnerable workers and participants exposed, failing to provide the level of oversight that a sector in transition urgently demands. We are concerned by the decision to exclude providers of Social and Community Participation supports from mandatory registration. Leaving these providers unregistered, subject only to the basic ‘enrolment tool’, risks creating unregulated pockets of the NDIS marketplace, safe havens where fraudulent operators, unregistered providers, and bad actors can hide. Further, support workers in community access and day service settings often operate with low levels of direct supervision, making them highly vulnerable to wage theft and poor safety standards.

The HSU argues that mandatory registration must be extended to these categories to fully realise the intended goals of the government’s reforms. Further, the government should take this opportunity to revitalise day programs under a structured commissioning framework, which would offer workforce stability while delivering higher-quality, socially integrated support. We also note our concern about the uncertainty of allied health roles under the reforms, and urge that registration for these types of supports must not become so administratively onerous that it drives sole traders and community health professionals out of the market.

Civil Penalties (Schedule 2, Part 2)

The Bill significantly expands the civil penalty framework by triggering Parts 2 and 3 of the Regulatory Powers (Standard Provisions) Act 2014 and introducing a range of new civil penalties. While the HSU supports strong penalties to deter corporate and provider misconduct, the union is concerned that these penalties will be disproportionately applied to unpaid family carers and plan nominees. Many plan nominees are aging parents or family members of participants who do not possess corporate accounting skills.

Applying heavy civil penalties to informal, unpaid carers creates an environment of fear and anxiety, discouraging family members from taking on nominee roles and placing a heavier burden on public advocacy systems.

Registered Plan Management Providers (Schedule 2, Part 6)

This section explicitly mandates a registration condition that a plan management provider and its related parties must not provide any NDIS supports or services other than plan management. The Explanatory Memoranda (EM) confirms the transition of plan managers to a panel arrangement following a competitive procurement exercise, providing a delayed commencement of up to 24 months to finalise contracts.

The HSU supports the transition to a Commissioned Panel for Plan Management services, which reflects the government’s efforts to reduce or eliminate widespread conflict-of-interest practices across the sector. For too long, the current approach – where providers manage the very budgets they are also paid to spend – has undermined the integrity of the Scheme. Moving to a commissioned panel model is a vital correction that restores the focus to impartial financial advocacy for the participant, rather than profit-maximisation for the provider.

This reform is a significant improvement on the status quo. To ensure it succeeds, the HSU urges the Government to ensure that institutional knowledge and service continuity are preserved through a funded workforce-transition package, rather than lost to the volatility of market-based competition.

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Schedule 3 – Governance Arrangements Pricing Decisions (Schedule 3, Part 1)

This section of the Bill transfers final pricing authority directly to the Minister, acting on the advice of the Agency following its Annual Pricing Review. The EM attempts to justify this shift by asserting that the Independent NDIS Review recommended the Australian Government take a more active role in price-setting; however we view this as a creatively misleading reframing of the Review’s central concern: that the NDIA suffers from an “inherent conflict of interest” by holding responsibility for both price caps and overall scheme sustainability. To mitigate this, the NDIS Review specifically recommended transferring responsibility for pricing advice to the Independent Health and Aged Care Pricing Authority (IHACPA)3. The government’s proposed model, however, effectively ignores this recommendation, instead placing pricing powers directly in the hands of the Minister.

Under this new model, while the NDIA remains responsible for providing pricing advice – including assessments of the cost of delivering safe, high-quality, and efficient supports, alongside considerations of market diversity and scheme sustainability – the ultimate decision-making power rests entirely with the Minister. By concentrating this authority in a political office rather than an independent body, NDIS pricing becomes dangerously susceptible to short-term fiscal pressures and federal budget cycles. When pricing decisions are driven by a multibillion-dollar savings target rather than the actual, independent cost of delivering quality, award-compliant services, it is the front-line workforce that inevitably bears the cost. We remain concerned that without the independent oversight of a body like IHACPA, there is nothing in this Bill to prevent pricing from being manipulated to suppress worker wages and compromise service standards. We urge the government to ensure that any differentiated pricing framework must be legally bound to a “wage pass-through” mechanism that guarantees support workers receive fair wages reflecting the complexity and location of their work.

➢ Recommendation: Transition to an Independent Pricing Authority

Instead of transferring final price-setting authority to the Minister, the Bill should place these powers under a completely independent, external pricing body (such as IHACPA); with a statutory mandate to set NDIS price limits based on the true cost of safe, high-quality, and award-compliant service delivery.

➢ Recommendation: Implement a “Wage Pass-Through” Mechanism for Pricing

Any legislative provision allowing for differentiated pricing must be legally bound to a “wage pass-through” mechanism. This ensures that any adjustments to price limits are transparently and directly applied to support worker wages, rather than being absorbed into provider margins.

Automated Decision Making (Schedule 3, Part 2)

This section permits the CEO to arrange for the use of computer programs to take automated administrative actions under specified provisions, including plan renewals and the grouping of supports. While the HSU acknowledges the need for administrative efficiency in processing over 660,000 claims a day, the union expresses serious concern regarding algorithmic risk.

Automated systems operate on rigid, binary rules that cannot account for the complex, highly individualised nature of severe disability. An automated suspension or revocation for an uncontactable participant could lead to devastating real-world outcomes where a highly vulnerable individual is left without essential, life-sustaining support due to a technological error or outdated contact details.

3 Independent Review of the NDIS. Final Report. https://www.ndisreview.gov.au/resources/reports/our-final-report-guide people-disability-and-their-families-2023

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The legislation must ensure that the Standard Operating Procedure instruments be subject to strict human-in-the-loop oversight, and that no automated system should have the power to suspend, reduce, or revoke a participant’s funding without active, human-led clinical review.

➢ Recommendation: Mandate Human-in-the-Loop for Automated Decisions

Amend the Bill to explicitly prohibit the use of automated decision-making systems for any function that can result in the suspension, reduction, or revocation of a participant’s funding. Any such action must require an active, human-led clinical review to prevent catastrophic outcomes caused by algorithmic or data errors.

Schedule 4 – New Framework Planning

Supports Needs Assessments

This section makes a series of amendments to the New Framework Planning model, including a specific requirement that a support needs assessment must be undertaken by an Agency staff member, a consultant engaged by the Agency, or a person prescribed by the NDIS rules.

We are concerned by the lack of statutory qualification and training requirements for these assessors. Support needs assessments are highly complex clinical tasks that require a deep understanding of physical, intellectual, and psychosocial disabilities.

If these assessments are outsourced to private consulting firms or conducted by under-qualified, short-term contract staff, the quality of planning decisions will deteriorate rapidly, leading to inconsistent, inequitable plan budgets and an increase in costly merits review disputes. The HSU argues that these assessments must be conducted exclusively by qualified, public-sector allied health professionals under secure, permanent employment arrangements. Schedule 5 – Transitional Rules

This section details transitional provisions, including how providers who are currently registered under the old framework will be legally managed when the new laws commence. It grants the Minister the power to make transitional rules that automatically deem existing registrations to transition into the new risk-proportionate tiers for a maximum period of 12 months, avoiding a regulatory bottleneck while the new compliance instruments are finalised. We broadly support these measures.

Other Concerns

National Worker Registration Scheme

The HSU is concerned by the Bill’s profound silence on the disability support workforce itself. While speeches given by the Minister have correctly identified that financial blowouts are the fault of greedy and dishonest operators rather than the disability community, the legislation contains no provisions to support, upskill, or fairly compensate the workers who deliver these critical services.

We have significant concerns about the absence of a comprehensive national worker registration framework. The legislation focuses heavily on corporate and provider compliance, but completely neglects individual worker professionalisation. A formal worker registration mechanism, linked to minimum qualifications and ongoing professional development, is essential to lifting service quality and protecting participants from abuse. Without this, the regulatory framework remains lopsided – policing corporate entities while ignoring the systemic under-valuation and lack of training within the front-line workforce.

This legislation is an opportunity for the government to introduce a nationwide pilot of an individual worker registration scheme. This pilot could be modelled on the existing, successful voluntary worker registration system currently operating in Victoria. Professionalising the workforce through a

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centralised register will establish clear career pathways, reduce the sector’s high turnover rate, and ensure that only screened, qualified workers are part of the Scheme.

➢ Recommendation: Establish a National Worker Registration Scheme

Amend the Bill to mandate the creation of a comprehensive, individual National Worker Registration Scheme, linked to minimum qualifications, professional standards, and secure employment pathways. The Commonwealth should immediately fund a nationwide pilot of this scheme, using Victoria’s voluntary worker registration model as a template.

The Impact of Cuts to Quality and Values-based Service Delivery

HSU members are focused on the quality of the sector, but the fear of government cuts leaves workers worried about job security and roster reductions. When funding is cut, providers often respond by immediately reduce the length and frequency of worker shifts to maintain their operating margins. This casualisation of the workforce drives away experienced, qualified staff, replacing them with transient, under-trained labour. We note that for participants in long-term supported accommodation, the workforce is not merely a service delivery mechanism; they are an essential part of their social networks and safety systems. High staff turnover directly increases the risk of abuse, neglect, and exploitation.

Our members have witnessed how the unchecked growth of for-profit providers has compromised service standards, as industrial investigations regularly uncover instances of sharp practices, wage theft, and inadequate worker supervision. Over successive years, the Scheme has increasingly attracted private equity and corporate capital, drawn by the prospect of extracting significant profits from government-funded services. Corporate providers often then prioritise profit margins over workforce conditions and participant outcomes. The NDIS must be returned to its values-based, non profit foundations. The structural changes in this Bill should be leveraged to discourage profit extracting corporate entities, redirecting public funds toward non-profit, public, and cooperative models of care that reinvest surpluses directly into worker wages and participant support.

Foundational Supports, Thriving Kids, and the Allied Health Bottleneck

We are concerned about a dangerous misalignment between the ambitious scope of Thriving Kids and the fragility of the workforce expected to deliver it. Members working in healthcare settings have expressed significant doubt that Thriving Kids will be sufficient to meet the clinical demand of children diverted from the Scheme, noting that public health settings are already severely overstretched.

Currently, the disability and allied health workforce operates under conditions of acute crisis, marked by chronic instability, burnout, and insufficient remuneration, posing an existential threat to the scheme’s viability. Without sector stabilisation and mandated training, Thriving Kids risks becoming a significant investment in a system unable to deliver the required quality outcomes.

Until more detail emerges on how the alternative pathways for participants will operate in practice, we remain cautious about what this means for people with disability and the workforce that supports them. Key questions remain unanswered: how will these programs be delivered, and how will the government ensure it has the workforce to deliver them effectively?

Ongoing Co-design and Consultation Frameworks

While the EM states a general intent that consultation will occur through the development of subsequent legislative instruments and rules, the exact structural mechanisms for formal union and worker consultation remain unspecified.

Further while the Bill legally anchors functional capacity definitions, the clinical thresholds and exact testing methods remain unmapped. The EM explicitly notes that the government will establish a

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Technical Advisory Group to advise on these methods, which will be detailed in future NDIS Rules rather than primary text, leaving the final criteria open for consultation.

➢ Recommendation: Formulate a Comprehensive, Co-Designed NDIS Workforce Plan

The government must establish a formal, structured framework for ongoing co-design and consultation with the HSU and other relevant unions throughout the design, rollout, and evaluation of all commissioned services, registration frameworks, and planning tools. This must be backed by a fully funded NDIS Workforce Plan focused on secure employment, wage growth, and mandatory training.

Conclusion

The HSU stands ready to support the Federal Government, in collaboration with the States and Territories, to make meaningful changes to the NDIS that will ensure the sustainability of the Scheme, while improving the working conditions of thousands of NDIS workers, in turn improving the quality of supports for the participants.

The long-term viability of the NDIS is fundamentally anchored in the security and professionalisation of its workforce. True sustainability cannot be achieved through unilateral budget contractions or the erosion of participant protections; it must be built upon a foundation of decent work, fair wages, and high-quality, values-based service delivery. We urge the Committee to reject the current trajectory of unchecked ministerial power and clinical narrowing, and instead adopt a model of genuine, tripartite co-design. Only by treating the disability support workforce as a central pillar of the scheme – rather than a fiscal variable to be adjusted – can the Government ensure a robust, equitable, and sustainable NDIS that truly serves all Australians for generations to come.

We cannot afford to design the exit from the NDIS the same way the scheme itself was built - on the run, without a plan. These reforms must be co-designed with all parts of the disability sector: workers in their unions, participants through their representative organisations, and providers via their peak bodies.

We would welcome an opportunity to speak at future public hearings this committee conducts.