Risk of financial discrimination in treatment access (Provider experience)

Submission 349

Submission to the Senate Community Affairs Legislation Committee

National Disability Insurance Scheme Amendment (Securing the NDIS for Future

Generations) Bill 2026

I am the owner and sole clinician at Evergreen Allied Health, an occupational therapy service supporting children and families in South-West Brisbane and Ipswich. With over 20 years of experience as an occupational therapist, and five years operating a private paediatric practice, I have worked extensively with children with developmental delay, autism spectrum disorder, cerebral palsy, and physical disability. My clients access supports through the NDIS, Medicare, and private funding.

I am writing to express my deep concerns regarding the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026. While I acknowledge the need for the Scheme’s long-term sustainability, I believe the proposed amendments risk undermining the foundational principles of the NDIS and may have significant negative impacts on people with disability, their families, and the broader community.

Key Areas of Concern

1. Tightening the Definition of “Permanent” Disability The Bill proposes that impairments may not be considered permanent unless all “appropriate treatment” has been undertaken and further treatment is unlikely to materially improve the impairment. Treatment may be deemed “appropriate” even if a participant cannot realistically access it due to financial or geographic barriers.

Concerns:

• The term “appropriate treatment” is not clearly defined, leading to uncertainty and potential for inconsistent application.

• Many people with lifelong disabilities require ongoing therapy, rehabilitation, or medical intervention to maintain function, reduce decline, or improve quality of life. Ongoing treatment does not mean a disability is temporary.

• The requirement to exhaust all treatment options may disproportionately disadvantage those who cannot afford private treatment or who live in areas with limited service access.

• There is a risk of financial discrimination and unrealistic expectations regarding treatment access.

Submission 349

• Children with disabilities, and those with degenerative or fluctuating conditions, may be unfairly excluded from the Scheme.

Many of the children I support with cerebral palsy, epilepsy, and other lifelong disabilities continue to engage in therapy and medical treatments to maintain function and quality of life. Ongoing treatment should not be a barrier to accessing disability supports.

2. Increased Reliance on Informal Supports and Parents The Bill strengthens the presumption that parents are responsible for a wide range of supports, focusing on the type of support rather than the intensity, frequency, or complexity.

Concerns:

• Parents of children with disabilities are often needing to provide care that is far more intensive and complex than would be required of a parent of a child without a disability of the same age.

• Increased reliance on informal supports risks carer burnout, family breakdown, reduced workforce participation and financial stress on families.

• Reducing formal supports may transfer risk and burden onto families already operating beyond sustainable capacity.

3. Funding Cuts, Funding Caps, and Ministerial Powers The Bill provides broad ministerial powers to reduce funding, apply percentage reductions, and set funding limits or caps for groups of participants or types of supports.

Concerns:

• Reducing funding does not reduce disability-related need; it transfers risk onto families and increases crisis presentations.

• Broad funding cuts may result in participants receiving supports below what is required for safety, participation, and independence.

• There are minimal legislative safeguards, limited transparency, and restricted appeal mechanisms.

Submission 349

Conclusion

The proposed Bill fundamentally reshapes eligibility, permanence, funding mechanisms, and participant safeguards.

I urge the Committee to delay implementation pending meaningful consultation and impact assessment.

Thank you for considering this submission.

Samantha Brekalo

Owner and Principal Occupational Therapist

Evergreen Allied Health

Brisbane, Queensland.