Hello,
I am writing as the Director of , a paediatric Occupational Therapy service based in , and as a clinician and business owner working alongside children and families every day.
I am increasingly concerned about the cumulative impact current NDIS changes and funding pressures are having on the sustainability of paediatric services in Victoria and the unintended consequences this may create for children, families and communities.
This is not a concern about providers protecting business interests.
This is a concern about whether children will continue to have meaningful access to support.
Across Victoria, private paediatric providers have become a significant part of the practical infrastructure supporting children with disability, developmental delay and neurodivergence.
Services like ours support families through assessment, therapy, parent coaching, school collaboration, capacity building and long-term developmental support. We often bridge the gap between systems when families cannot access public services in a timeframe that meets their child’s needs.
Over recent years, we have seen increasing pressure across the sector through:
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reduced funding availability and tighter interpretation of supports
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increased administrative burden and evidence requirements
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delayed decision-making and planning processes
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rising operating and workforce costs
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increased clinician burnout and workforce movement
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growing uncertainty for families trying to plan ongoing care
At the same time, demand for services has not reduced.
Children still need support.
Families still need guidance.
Schools still need collaborative care.
But the capacity of providers to continue delivering these supports is becoming increasingly fragile.
If these pressures continue without careful consideration of provider sustainability, there is a real risk that experienced paediatric businesses across Victoria will become financially unviable.
That means:
- clinics reducing staff or closing entirely
- clinicians and support staff losing jobs
- fewer student placement opportunities and reduced future workforce growth
- increased waitlists across all systems
- reduced access for outer metropolitan and regional communities
- fewer providers willing or able to support complex presentations
- reduced choice and flexibility for families
Most importantly, it means children losing access.
Many families have spent years building trusted therapeutic relationships.
Therapy is not interchangeable.
For many children — particularly neurodivergent children and those with developmental differences — progress relies on consistency, trust, safety and relationships developed over time.
When services reduce or disappear, children do not simply transfer without impact. Progress can stall. Families disengage. Children miss developmental opportunities. Those impacts can be lifelong.
Too often discussion focuses only on “early intervention”, but children do not stop needing support at nine years old.
Many services rely on supporting children across a broad age range to remain viable.
If provider sustainability declines, older children are frequently the first group to lose access despite continuing needs. This creates downstream impacts on:
- school participation and attendance
- emotional wellbeing and mental health
- independence and daily living skills
- community participation
- transition to adolescence and adulthood
- future employment and workforce participation
These consequences extend well beyond therapy.
Parents reduce work. Grandparents increase caring responsibilities. Schools absorb unmet needs. Communities lose local services. Enterprises lose workforce participation. And families carry greater pressure with fewer supports.
Families see these impacts directly. Communities see them directly.
These are not future hypotheticals — many providers and families are already experiencing the early signs.
I strongly believe reform and sustainability can exist together. But achieving that requires recognising experienced private providers as part of the solution, not an optional extra.
I respectfully ask decision-makers to consider:
- assessing the cumulative impact of NDIS changes on provider sustainability
- protecting continuity of care for existing families
- ensuring funding approaches support long-term service viability
- reducing unnecessary administrative burden
- engaging directly with frontline providers and families before further changes
- recognising the value of mixed service ecosystems across public, private and community sectors
- considering the long-term economic and social costs of reduced access to early and ongoing support
The success of reform should not be measured by reduced expenditure alone.
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It should be measured by whether children can still access quality support in their local communities when they need it.
I welcome opportunities to contribute to consultation and discussion to ensure Victoria maintains a sustainable, accessible and high-quality paediatric support system for children and families.
Kind regards,
Director | Paediatric Occupational Therapist