National Disability Insurance Scheme cuts will leave children without care, allied health therapists warn

Vulnerable WA children will lose access to vital therapy because of “devastating” changes to the National Disability Insurance Scheme’s pricing, allied health professionals have warned. From July 1, the National Disability Insurance Agency will reduce or freeze the hourly rates physiotherapists, psychologists, speech pathologists and dietitians can charge NDIS patients. In addition, claimable travel time will be capped at 50 per cent. Physiotherapist rates will drop $10 to $183.99 per hour, dietitians and podiatrists will drop $5 to $188.99 per hour and in WA, psychologists will receive a reduction of $11.23 an hour under a national price limit of $232.99 an hour. The NDIA said the changes were based on Medicare and private health insurance data which suggested many NDIS therapy pricing limits were “out of step” with broader markets rates. And it said the new travel-claiming rules would help participants’ plans go further, as some participants were currently being charged more for travel than they were for the therapy itself. But clinicians and families are calling on the Government to reverse the decision, which they say will leave many children with disabilities without access to life-changing treatment. Some families have already had appointments cancelled ahead of the changes coming into place from Tuesday. More than 50,000 Australians have signed a petition warning the cuts will limit access to care, particularly in rural and remote areas. Under the scheme many patients receive treatment from visiting clinicians at home or in school, which is considered best practice and also reduces the burden on families who would otherwise have to travel to numerous in-clinic appointments each week. Some therapists, who spend hours each week travelling between patients, say cuts to the travel allowance means they will have to limit or cease their mobile services. Kiara mother and psychologist Teneille Williams will be affected both professionally and personally. She works with neurodivergent children, including those with complex trauma or diagnoses of autism or attention deficit hyperactivity disorder, and said the changes will dramatically reduce her ability to deliver safe and effective services. “I can no longer bill adequately for travel; outreach services such as in-school may no longer be available, and I may be forced to reduce my NDIS caseload, which would limit access for families who specifically seek trauma-informed, neuroaffirming care,” she said. She is also a parent of two children with disabilities, including Zoe, eight, who receives school-based therapy under the NDIS. “The impact is deeply distressing . . . as a single parent, the withdrawal of reasonable accommodations (like school-based therapy) places our family at risk of regression, and crisis,” Ms Williams said. “Zoe has such potential and it terrifies me that these changes are being made by people who have no experience or clinical understanding about the impacts of said choices. “I want my child to reach their potential and the idea that government officials are impeding that is heart-breaking.” Speech pathologist Demi Williams services areas such as Wundowie, Chidlow and Wooroloo, but will now close her mobile service as a result of the “devastating” changes. “These children will now be left without access to care. I will no longer be able to run a fully mobile service. Families who cannot travel to me will simply go without,” she said. “These changes are pushing dedicated professionals out of the field, while pushing vulnerable children further to the margins.” Among her patients is a nine-year-old boy with complex autism and an intellectual disability. He is non-verbal, and has a history of violent behaviour but is now comfortable with Ms Williams and making progress. “The Government will never see how I have changed this family’s life,” she said. “I will no longer be able to see him. “I have devoted my career, and much of my personal life, to supporting some of the most vulnerable children in our community. I work with the most complex cases, the children who are often turned away elsewhere. “But right now, the government’s message is unmistakable: I am not valued, I am a ‘price gouging greedy therapist who takes advantage of disabled children’.” Speech pathologist Holly Tickner from Next Bite Paediatric Feeding Centre said the benefits of receiving treatment at home, school or childcare centres was huge for patients and their families. “Seeing kids in their natural environment is what we are encouraged to do, but the NDIS is not providing the support for us to do that,” she said. “This is going to have a significant impact on families. Some of the kids I see have significant physical disabilities, they are in wheelchairs or have oxygen tanks, it’s not easy for them to jump in the car or for mums to take half a day off work to get them to appointments several times a week.” Allied health professionals who spoke with The West Australian said they had been “blindsided” by the changes, which come after a five-year pricing freeze across the industry which had already “stretched NDIS providers to breaking point”. Industry peak bodies impacted by the changes have called on the Federal Government to review the pricing recommendations and index prices to CPI. They argue price guides have been frozen since 2019, despite rising operational costs. Nicole Pates, chair of the Australian Physiotherapy Association’s national paediatric committee, said the NDIA’s methodology in coming up with the pricing was flawed, as it was not reflective of the complex nature of working in the NDIS. “It devalues physiotherapy as a profession, you’re asking (mostly) women working with disabled people to do the same work for less pay and more stress, and there are unintended consequences of that,” she said. “I don’t know of any other industry in Australia that has had a price cut, it’s unprecedented.” Ms Pates said the changes would increase pressure on the hospital system as patients lost access to vital physio treatment. “Physiotherapists have a significant role to play in keeping kids and adults with a disability healthy, mobile and participating in life,” she said. Therapy support payments account for a significant proportion of NDIS funding, totalling $2.4 billion in the six months to December 2024. An NDIA spokeswoman said the pricing review found some inflated therapy price points, and as a result the new price points had been adjusted to align to non-NDIS market rates. “These changes ensure NDIS participants, funded by Australian taxpayers, are not paying significantly higher rates for some services than those outside of the NDIS,” she said. “It’s not fair or acceptable that NDIS participants pay higher prices for supports. In some cases, NDIS price limits were higher than non-NDIS prices by up to 68 per cent.”