Submission 3373 — Name Withheld — NDIS Future Generations Bill | External submission

To whom it may concern,

I am writing as an Occupational Therapist who has worked primarily in the public not for-proﬁt sector and more recently in the private sector for the last 18 years.

This submission outlines my concerns regarding the proposed NDIS Future Generations Bill and its potential impact on participants, families, carers, and the allied health workforce.

Functional capacity assessments and assessment design The repurposing of the term “functional capacity assessment” puts participants at risk of having their true function, participation, and daily support needs misunderstood or misrepresented. This places some of our most vulnerable community members at risk of losing access to the people, places, and occupations that give their lives meaning and support their wellbeing.

Allied health professionals registered through AHPRA have a professional and ethical duty to assess individuals holistically and objectively. Occupational therapists, in particular, are uniquely trained to understand a person’s functional capacity within the context of their environment, support systems, daily activities, goals, and barriers to participation. Through clinical reasoning, observation, and collaboration, OTs can identify supports that are both evidence-based and meaningful to the individual.

In paediatric practice, I frequently work with families who have become so accustomed to the level of care they provide that they no longer recognise how signiﬁcantly it differs from what would be expected for a child of the same age. Parents will often tell me that things are “ﬁne” or that they are “managing”. However, further discussion reveals that they are bathing their eight-year-old child, dressing them each morning, changing nappies because the child is unable or too fearful to use the toilet, carrying their belongings and navigating multiple meltdowns before they can even leave the house, often arriving late to school.

Many of these parents are exhausted, but they minimise their struggles because they do not want to complain, be seen as incapable, or become a burden on the system. They have adapted to a level of care that has become their normal. A standardised assessment or automated process may record that the family is coping and therefore conclude that support needs are low. An experienced occupational therapist understands that what is being described is not typical childhood independence and that the family’s ability to continue providing this level of care often comes at a signiﬁcant emotional, physical, ﬁnancial, and social cost.

This is precisely why professional clinical judgement is essential. Occupational therapists are trained not only to identify what a child can do, but also the level of support required, the impact on family functioning, and the barriers preventing

participation in everyday life. Without this level of understanding, there is a real risk that children and families will be assessed as requiring less support than they actually need.

Throughout my career, I have also witnessed the consequences of important decisions being made by individuals who lack the training, clinical expertise, or understanding of functional capacity required to make those decisions safely. When assessment processes are disconnected from appropriately qualiﬁed professionals, participants are placed at risk and resources are often used inefficiently. Functional capacity assessments should remain the responsibility of appropriately qualiﬁed allied health professionals, including occupational therapists, who are trained to understand the complex interaction between disability, function, environment, and participation.

Reliance on automation, algorithms and standardised tools The Bill’s increased reliance on automation, algorithms, and standardised assessment tools raises signiﬁcant concerns. Human beings are complex, and disability does not exist in a vacuum. People’s support needs are inﬂuenced by their environment, relationships, health, culture, and life circumstances. These complexities cannot be adequately captured through a tick-box exercise or automated decision-making process.

While standardised tools can play a role in informing assessments, they should never replace professional judgement. Decisions regarding eligibility, funding, and supports should always include meaningful human oversight by appropriately qualiﬁed professionals. Without this safeguard, there is a signiﬁcant risk that participants and their carers will have their needs misunderstood, resulting in poorer outcomes and increased pressure on already stretched health and community systems.

Recent concerns regarding the use of standardised assessment tools in other sectors demonstrate the risks of relying too heavily on systems that cannot adequately account for individual circumstances. The NDIS must not repeat these mistakes.

Ministerial powers and system-wide funding decisions The Bill’s expansion of ministerial powers to limit or reduce entire categories of supports is deeply concerning. The NDIS was established to provide individualised support based on a person’s functional needs, goals, and circumstances. Broad funding decisions made at a system level risk undermining the principles of choice, control, and individualised support that sit at the heart of the Scheme.

People with disability should not lose access to necessary supports because of broad policy decisions that fail to consider individual circumstances. There are numerous opportunities to address issues such as overspending, fraud, and inefficiency without reducing access to legitimate supports that enable participation, independence, and quality of life.

Transparency, accountability, and evidence-based decision-making are essential. Decisions that affect entire categories of supports should be subject to robust consultation with participants, families, carers, disability advocates, and appropriately qualiﬁed professionals.

Access to the Scheme, reassessment, and capacity-building supports I am concerned that the Bill may narrow access to the Scheme in practice, particularly for children, people with psychosocial disability, and individuals with complex, ﬂuctuating, or degenerative conditions. These are often the very people whose needs are least suited to standardised assessment approaches.

Early intervention and ongoing support are critical. As a paediatric occupational therapist, I am now seeing the long-term outcomes of supports that were provided to clients over the last 5-6 years. Some of the children I ﬁrst worked with as three-year olds are now eight or nine years old. Through access to high-quality occupational therapy and capacity-building supports, many have developed the skills needed to participate more independently at school, engage in their communities, build friendships, and manage challenges that once signiﬁcantly affected their daily lives.

Importantly, their families have also developed the knowledge, conﬁdence, and practical strategies needed to support their children and respond to challenges as they arise. As a result, many of these children now require less intensive therapy than they did in the early years and some are ready to “graduate” from the scheme entirely. This is precisely what capacity-building supports are designed to achieve: building skills, increasing independence, strengthening families, and reducing long-term reliance on services.

My concern is that decisions about reducing access to these supports are being made too early to fully appreciate the beneﬁts they have already delivered. Many of the children who received early intervention through the NDIS are only now reaching an age where the cumulative impact of those supports can be clearly seen. The increased independence, participation, and family resilience we are witnessing today are the direct result of investments made years ago. Without continued access to high-quality early intervention and capacity-building supports, future generations of children may not achieve these same outcomes.

I am concerned about proposals to restrict reassessment processes. Disability-related needs can change unexpectedly due to health deterioration, developmental changes, life transitions, or changes in support networks. Participants must have practical pathways to seek reassessment when circumstances change. Many degenerative childhood conditions are misunderstood by the NDIA and I have recently seen an example of an automatic cut in funding to a child’s plan as there is an expectation after years of therapy that the child’s participation should be improving, despite evidence to

the contrary. Confusion about the main diagnosis being Autism (which is not the case) lead to this detrimental error. Restricting reassessments to exceptional circumstances may leave people without the supports they require to remain safe, independent, and engaged in their communities.

Similarly, capacity-building and participation supports are often misunderstood as optional when they are, in fact, fundamental to improving long-term outcomes. These supports help people develop skills, increase independence, participate in education and employment, maintain social connections, and reduce reliance on more intensive supports in the future. Reducing access to these supports may ultimately increase long term costs while diminishing quality of life for participants and their families.

Conclusion

The NDIS requires reform, but reform must be informed by evidence, professional expertise, and the lived experience of people with disability. The most effective solutions will come from meaningful consultation with participants, families, carers, and the clinicians who work alongside them every day.

I urge Parliament to ensure that:

· Functional capacity and support needs assessments are conducted by appropriately qualiﬁed allied health professionals, including occupational therapists, whose training, registration requirements, and ethical obligations equip them to assess individuals holistically and accurately.

· Standardised assessment tools and algorithms are used only to support, and never replace, professional clinical judgement. Fully automated eligibility and funding decisions should be prohibited.

· Funding decisions remain based on individual need, clinically informed assessment, and participant goals rather than broad funding restrictions applied across categories of support.

· The Bill does not operate to narrow access to the Scheme, particularly for children, people with psychosocial disability, and those with complex, ﬂuctuating, or degenerative conditions.

· Children continue to have access to high-quality early intervention and capacity building supports, recognising the long-term beneﬁts these supports provide to children, families, communities, and the sustainability of the Scheme itself.

· Participants retain practical, accessible pathways for reassessment and review when their circumstances, needs, or functional capacity change.

· Capacity-building and participation supports are protected and recognised as essential investments that promote independence, participation, skill development, family resilience, and reduced long-term reliance on services.

· Government consult more closely with people with disability, families, carers, occupational therapists, and other allied health professionals when designing and implementing future NDIS reforms.

· Pricing, registration, and integrity reforms support a sustainable, clinically governed allied health workforce capable of delivering high-quality services to participants across Australia. AHPRA registration should be recognised along with substantial training and education required to gain a degree in the ﬁrst place.

· Ministerial powers are appropriately limited to ensure transparency, accountability, and the preservation of individualised decision-making within the NDIS.

The future of the NDIS should be shaped by those with the expertise, experience, and lived understanding necessary to create a system that is sustainable, equitable, and capable of delivering on its original purpose: enabling people with disability to live meaningful lives with dignity, choice, and opportunity.

Yours sincerely,