Submission to the Senate Community Affairs Legislation Committee National Disability
Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026
Submitted by: Contact:
Location: Nambour, Sunshine Coast, Queensland
About me and why I’m writing this
I'm a speech pathologist and I run , a small private practice on the
Sunshine Coast. I work with children and young adults who have communication, language, and speech difficulties — many of them funded through the NDIS.
I’m not writing this as a business owner worried about my revenue. I’m writing it because the people I see every week are real people, and I can see clearly what these changes will mean for their lives.
I want to be honest from the outset: I understand the NDIS is over budget. I support accountability, fraud prevention, and long-term sustainability. But this Bill, as written, does not fix those problems. It shifts the budget constraints — onto disabled people, onto families, onto hospitals, and onto a community services sector that is already at its limit.
- My clients will lose access to communication support that they rely on in their day to day lives
The children and adults I support use speech therapy to help them communicate — to ask for what they need, to participate at school, to hold down a job, to stay connected to their families. For many of them, this is not optional. Without it, function declines. Without it, the support needs increase.
Many of our young adults are focused on communication support that will enable them to engage in the workplace — understanding instructions, engaging in multiple communication turns, knowing what appropriate topics are for a work environment. They are receiving support to try to get a job. That is exactly the kind of outcome the NDIS was designed to build toward.
The proposed 10% cut to Capacity Building Daily Activity budgets (Schedule 1, Part 6, s.34A) hits speech pathology directly. For a family already stretching to use their child’s NDIS funding efficiently, 10% fewer funded sessions is the difference between weekly therapy and fortnightly therapy. The research on early communication intervention is clear — frequency and consistency matter. You cannot achieve the same outcomes with less.
I also want to name something that concerns me deeply as a clinician. The amended “effective and beneficial” test (s.34(1)(d) and new s.34(1E)) ranks published, generalisable research as the highest priority — above individual clinical evidence. Speech pathology has a strong evidence base, but the children I see do not present as populations. They present as individuals. A child with autism, a co-occurring language disorder, a history of trauma, and
limited family capacity to implement home programs needs a clinical plan built around their specific circumstances — not a population average. The Bill explicitly allows the NDIA to reject a support even where strong individual clinical evidence exists, if the generalisable research is limited. That is a direct threat to person-centred practice, which the government itself acknowledged in its best practice framework for early intervention.
Additionally, the amended “value for money” test (s.34(1)(c)) removes the longstanding requirement that a cheaper alternative support must achieve the same or substantially similar outcome. The new test requires only that a cheaper support exists and is considered better value — without any requirement it produces equivalent functional benefit, equivalent safety, or equivalent independence. For a child with complex communication needs, “cheaper” and “equivalent” are rarely the same thing.
- Assessments will not capture how disability actually presents — especially for fluctuating conditions
The new functional capacity test introduced at section 9B defines functional capacity as what a person can do without assistance from other people, without assistive technology or modifications, and excluding — as far as possible — environmental and personal circumstances. The Explanatory Memorandum confirms this test will apply to all current NDIS participants, not just new applicants, from 1 January 2028 (EM 143).
This is a fundamental departure from how functional capacity is understood and assessed in allied health practice. In speech pathology, as in occupational therapy and all evidence-based disability practice, function is assessed in context — with familiar communication partners, in familiar environments, across different times of day and different demand levels. That full picture is what determines realistic support needs.
Many of the people I work with have fluctuating or context-dependent presentations. A child with autism who is verbal in a quiet one-on-one clinic assessment may be completely unable to communicate during sensory overload at school. A young adult with a language processing disorder may manage a structured task on a low-demand day but lose the thread entirely in a fast-moving team meeting. A person with ME/CFS or multiple sclerosis may be able to complete a task briefly but be unable to function at all for two days afterwards.
A standardised assessment administered by a non-allied health NDIA employee on a single day, deliberately stripped of environmental context, cannot capture any of this. It will capture peak performance under controlled conditions. It will systematically underestimate the support needs of anyone with a fluctuating, episodic, fatigue-related, or context-dependent disability — which describes the majority of people I work with.
Furthermore, under the amended reasonable and necessary criteria, the support needs assessment tool and its methodology, thresholds, and classifications will be defined through future NDIS Rules (s.9B and associated provisions). The detail of how assessments will actually work has not been published. The Committee is being asked to pass legislation that hands over extraordinary power to determine eligibility without the community being able to see or respond to the assessment tool that will be used to exercise it.
I ask the Committee to recommend that the functional capacity definition be amended to require that fluctuating and context-dependent presentations be explicitly captured, and that treating clinicians’ evidence about a participant’s presentation across environments and circumstances be given equal weight to the standardised assessment outcome.
- The “appropriate treatment” requirement creates a circular trap for therapy recipients
Schedule 1, Part 8 of the Bill amends sections 24 and 25 of the NDIS Act to specify that an impairment will only be considered permanent if all “appropriate treatment” to remedy or alleviate the impairment has been undertaken, and no other treatment is likely to materially improve the impact of the impairment.
“Appropriate treatment” is defined as treatment that is evidence-based, regularly undertaken in Australia, and reasonably expected to materially improve, reverse, or alleviate the impairment. The only exemption from the exhaustion requirement is treatment that cannot be undertaken for medical reasons. Financial barriers and geographic barriers do not exempt a person.
This is deeply concerning for anyone in regional Queensland, where specialist services routinely carry waitlists of twelve months or more and may require travel to Brisbane to access. But the concern I want to raise specifically as a speech pathologist is this: speech therapy is, by definition, treatment that alleviates the impact of a communication impairment. That is what it does. That is what the evidence base supports.
Under the literal reading of these provisions, a child who has received speech therapy and has made meaningful communication gains could be assessed as having a condition that has been sufficiently “alleviated” — and therefore as no longer having a permanent impairment meeting the access threshold — and therefore as no longer eligible for NDIS funding. The therapy that demonstrates the disability is real, that it responds to skilled intervention, and that ongoing support will continue to build capacity — that therapy becomes the evidence used to argue funding for more of it is no longer warranted.
This is circular, and it appears to have gone unexamined in the drafting process. The Bill does not define where the boundary sits between medical treatment, rehabilitation, therapy, and capacity building. That boundary will apparently be set through future instruments, without the community knowing in advance where it falls.
I ask the Committee to recommend that the definition of “appropriate treatment” be amended to explicitly exclude ongoing allied health therapy and capacity building supports from the exhaustion requirement, and that the exemption for inaccessible treatment be expanded to include financial and geographic barriers, not only medical contraindications.
- Families will be left with impossible choices and reduced incomes Many of the families I work with are already doing far more than “ordinary parenting.” They are managing complex schedules, school suspensions, meltdowns, running communication programs at home, attending every therapy appointment, and coordinating with schools — all while working, if they can.
The Bill explicitly strengthens the presumption that parents are responsible for providing substantial care and support for their children, regardless of the child’s disability (s.34(1)(e) and new ss.34(1G)–(1H)). “Substantial care and support” is defined in the Bill to include supervision, personal care, transport, emotional support, behavioural support, and assistance with activities of daily living. This language will be used to reduce funded support for children on the basis that parents should be providing it.
The problem is that what looks like parenting from the outside is often something entirely different. A parent spending four hours a day managing a child’s sensory dysregulation, implementing a carefully designed communication system, and running a behaviour support plan is not doing ordinary parenting. That is specialist support being delivered by someone who has not slept properly in years and has no backup when they are sick. The intensity, frequency, and complexity of that support is vastly different from what is typically expected of a parent of a non-disabled child of the same age — and the Bill does not require that distinction to be made.
If that support is reduced because it looks like parenting on paper, the family does not suddenly have more capacity. They just have less help.
- The gap left by Thriving Kids is real, uncosted, and will fall hardest on regional families
I want to be careful here because the details of Thriving Kids remain unconfirmed, particularly in Queensland. But the direction is clear: children under nine with low to moderate support needs will move off the NDIS and into state-commissioned services.
What I can say from where I sit: the Sunshine Coast is not inner Sydney. The community based commissioned services that might work in a metropolitan area with high provider density do not exist here in the same way. Small private practices like mine are often the only locally available speech pathology service for families. If Thriving Kids is delivered exclusively through state-commissioned not-for-profit providers, those families lose access to the therapist who already knows their child — and in many cases, they lose access to any local therapist at all.
The Medicare rebate picture is not a solution. The current maximum Medicare rebate for speech pathology is $87.25 per session. A standard 45-minute session costs $220–$260. For families currently accessing NDIS-funded therapy with no out-of-pocket cost, that gap — $130 to $175 per session, every week — is simply not accessible. These are not wealthy families choosing a premium service. These are families who were only getting support because the NDIS existed.
- Cutting community participation funding has consequences that haven’t been costed The 50% cut to social and community participation budgets (s.34A) is being framed in public commentary as targeting discretionary lifestyle spending. I want to push back on that framing directly.
For many participants, community access funding is how they get to the GP. It is how they get to speech therapy, physio, the grocery store, the pharmacy. It is what keeps them connected to other people so that their mental health does not deteriorate to the point of requiring hospitalisation. It is the hours in the day where a carer can sleep, shower, or attend their own medical appointment.
When that support is cut, the need does not disappear. The person still needs to get to the GP. The carer still needs to rest. The question is just who pays, and how. The answer, in most cases, is the hospital system. Emergency departments. Mental health acute services. Centrelink. Aged care, when a carer can no longer cope. These are not cheaper systems. They are dramatically more expensive systems — the cost just sits in a different budget line, so the saving looks real.
I ask the Committee to seek a whole-of-government cost analysis before this Bill passes. The $37.8 billion in projected savings must be offset against what Treasury expects other systems to spend picking up what the NDIS drops.
- Ministerial powers are being concentrated without consultation requirements, parliamentary oversight, or right of review
I want to be direct about what the following three provisions, taken together, mean in practice.
Section 34A gives the Minister the power to reduce funding in any support category by any percentage, by legislative instrument, for reasons of financial sustainability. The Explanatory Memorandum at paragraph 285 explicitly confirms that changes made under this power are not subject to merits review. A participant whose funding is reduced under a section 34A instrument has no individual right of appeal.
Section 33(2EA) gives the Minister the power to cap maximum funding amounts, maximum hours of support, or maximum staffing ratios for any support or class of supports — again by legislative instrument. The Explanatory Memorandum at paragraphs 1424–1426 allows the actual cap values to sit in a document incorporated by reference, which means those numbers can be changed without Parliament seeing them again. The cap rule stays disallowable. The number underneath it does not.
Schedule 5 provides what legal commentators have described as a “Henry VIII power” — the ability to modify how the entire NDIS Act operates for twelve months through “transitional” rules, with no requirement for community consultation. The 2024 NDIS Supports Rules were
introduced as transitional provisions and remain in force nearly two years later, amended multiple times.
Taken together, these three provisions allow a single Minister, without a parliamentary vote, without mandatory community consultation, and without individual right of appeal, to reduce any participant’s funding in any category by any amount, cap the hours of any therapy type, and modify the operation of the Act itself. There is no equivalent concentration of power over any other major social support program in Australia.
This is not targeted anti-fraud reform. It is a structural shift that places the lives and daily functioning of disabled Australians within the discretion of a single ministerial office.
I ask the Committee to recommend that section 34A be amended to require mandatory co design and community consultation before any percentage reduction is made, and that individual merits review rights be retained where a reduction causes material harm to a participant. I ask that actual cap values under section 33(2EA) be required to sit in a disallowable instrument, not an incorporated document. And I ask that the Schedule 5 transitional power be narrowed to specifically enumerated matters, with mandatory consultation and a published impact statement required before any such rule is made.
- The private allied health sector is being quietly dismantled The combination of changes in this Bill — therapy budget cuts (s.34A), ministerial caps on therapy hours (s.33(2EA)), the move of under-nines off the NDIS, and the shift toward commissioned services — amounts to a deliberate compression of the private allied health market.
That market did not develop because of greed. It developed because there was an enormous unmet need and the public and not-for-profit systems could not meet it. Private speech pathologists, OTs, and physiotherapists built practices, trained staff, invested in services, and expanded into regional areas specifically because NDIS funding made it viable. AEIOU Foundation — one of Australia’s most respected early intervention providers for autistic children — went into liquidation earlier this year. That did not happen by accident. The deliberate freeze on price increases, the prohibition on gap payments, and the ongoing vilification of allied health providers in public commentary have been policy choices. According to the Reserve Bank of Australia’s inflation calculator, the current NDIS allied health hourly rate of $193.99 should now be approximately $249.01 to reflect real cost increases since it was set. Every year practices have faced rising costs with no relief. Allied health practices are closing across the country.
When private practices close, they do not come back quickly. The workforce disperses. The buildings are repurposed. The waitlists that took years to reduce start growing again. And families in regional areas like the Sunshine Coast, who were already facing twelve-month waits before the NDIS, go back to having no access at all.
This is not a business concern. It is a community infrastructure concern, and it deserves to be named as such.
What I am asking the Committee to recommend
I am asking the Committee to recommend the Bill not pass in its current form, and that the following specific changes be made before any passage:
That the therapy budget cuts under s.34A not proceed without discipline-specific evidence, particularly for paediatric communication intervention, where the research strongly supports frequency of treatment.
That the functional capacity definition under s.9B be amended to require that fluctuating, episodic, and context-dependent presentations be explicitly captured, and that treating clinicians’ evidence be given equal weight to standardised assessment outcomes.
That the “appropriate treatment” definition under ss.24–25 be amended to explicitly exclude ongoing allied health therapy and capacity building from the exhaustion requirement, and that the exemption for inaccessible treatment be expanded beyond medical contraindications to include financial and geographic barriers.
That the amended “value for money” test under s.34(1)(c) be restored to require that a cheaper alternative support achieve equivalent outcomes, not merely cost less.
That the definition of parental responsibility under ss.34(1G)–(1H) include explicit acknowledgment that the intensity, frequency, and complexity of disability-related support for children may far exceed ordinary parenting, and that this distinction be required to be reflected in planning decisions.
That the Thriving Kids delivery model be confirmed to include private community allied health providers, and that a no-gap or clearly defined low-gap fee structure be established before any children are transitioned off the NDIS.
That a whole-of-government fiscal impact analysis be published before the Bill passes, accounting for the cost to health, mental health, emergency, housing, and carer support systems of the supports being removed.
That section 34A be amended to require mandatory community consultation and a published impact statement before any percentage reduction, with individual merits review rights retained where a reduction causes material harm.
That actual cap values under s.33(2EA) be required to sit in a disallowable legislative instrument, not in an incorporated document that can be amended without parliamentary scrutiny.
That the Schedule 5 transitional rule-making power be narrowed to specifically enumerated matters, with mandatory consultation and a published impact statement required before any such rule is made.
That the Senate extend the consultation period. Fifteen days is not adequate time for families, clinicians, and providers to respond meaningfully to 113 pages of legislation and 289 pages of explanatory memorandum. The people most affected by this Bill had the least capacity to engage with it in the time given.
I support a sustainable NDIS. I have seen what it does for people. I have watched children find their voice, adults regain independence, and families breathe for the first time in years. That is worth protecting.
This Bill, as written, does not protect it.