Allied health professionals and NDIS participants across Australia are reeling from sweeping changes to National Disability Insurance Scheme (NDIS) pricing, which many say could lead to cancelled services, clinic closures and declining health outcomes, particularly in rural and remote communities.
From 1 July, the NDIA will slash travel allowances for therapists by 50 per cent and freeze the hourly rates of most allied health services. While the hourly rate for physiotherapy will drop nationally by $10, in some regional areas the cut exceeds $40 due to the removal of regional loadings.
The decision has blindsided many, with just 20 days’ notice given before the changes come into effect.
Helen Lowe, director of Through Life Physio in Warragul, Victoria, said the lack of consultation with the physiotherapy, occupational therapy and speech pathology sectors was both shocking and cruel.
“There’s been next to no consultation with our professional bodies,” Ms Lowe said. “It’s such an insult to us as practitioners that the NDIS thinks this is OK, and it is incredibly cruel on NDIS participants.”
Ms Lowe estimated her clinic will lose around $34,000 a year, which could force her to either pass the cost on to clients or withdraw services from rural homes, kindergartens and schools. She believes this goes against the spirit of disability-inclusive care.
“Travel isn’t a luxury,” she said. “To do good disability physio, you need to go where people are.”
Her client, Keryn Smith, who has an acquired brain injury and has worked with Ms Lowe for 13 years, credited physiotherapy with giving her back her independence.
“Physio changed my life,” she said. “If I didn’t have physio, I couldn’t live here by myself.”
Ms Smith said she was deeply frustrated by the changes, which she believes undermine the value of therapy for people living with disability.
“They think physio is unimportant,” she said. “It’s not.”
Similar concerns are being echoed across the country, including in the Kimberley and Pilbara regions of Western Australia, where vast distances make travel an unavoidable part of therapy delivery.
Caitlin Breheny, director of Connect Paediatric Services in Karratha, said the cuts make it unsustainable for her team to continue serving remote communities.
“We know children are going to miss out,” she said. “We can’t absorb this financially. It’s just unsustainable.”
Fly2 Health, which travels to extremely remote towns like Balgo in the WA desert, is now reviewing whether it can continue servicing those communities. CEO Kennedy Lay warned that pulling out would force some residents to travel hundreds of kilometres for basic therapies, if they can access them at all.
“If we’re forced to withdraw, people in these communities will be left with nothing,” he said.
Leanne Wishart, CEO of Gippsland Disability Advocacy, said the cuts breach the rights of people living with disability in rural and remote areas.
“This creates an even greater inequity in access to NDIS services,” she said. “It goes against the Disability Discrimination Act and the UN Convention on the Rights of Persons with Disabilities.”
In Wickham, WA, mother Janel Went fears for the future of her two daughters, who rely on multiple NDIS-funded therapies. Her family has already lost access to one occupational therapist due to cost issues.
“We’ve been told we’ll have to drive long distances or use telehealth,” she said. “But our little ones are too young for online sessions. They need hands-on support.”
Ms Went called for proper consultation with families living in regional communities.
“They’ve looked at figures, not impacts,” she said.
In a statement, the NDIA said the changes were necessary to ensure NDIS participants were not being charged more than clients using Medicare or private health.
“In some cases, NDIS price limits significantly exceeded the market rate by up to 68 per cent,” a spokesperson said. “We also heard that excessive travel claims were draining participants’ plans faster than expected.”
The agency claims rural and remote clients are still protected by loadings of 40 to 50 per cent, though practitioners argue those loadings have been inconsistently applied or removed altogether in some regions.
David Dinca, managing director of Ignite Healthcare, criticised the short notice and lack of transparency, warning of an exodus of professionals from the sector.
“Tens of thousands of professionals are going to have to walk away,” he said. “How are we meant to redesign our businesses in three weeks?”
Ashlee Lance, director of Treehouse Paediatrics, said her clinic may soon stop accepting new NDIS clients.
“We’ve got a couple of weeks to turn our entire service model on its head,” she said. “We’ll continue to support the kids we’ve got, but we’re taking a loss and that’s not sustainable.”
Australian Physiotherapy Association President Rik Dawson agreed.
“Physiotherapists aren’t going to have the capacity to see these people,” he said. “There was no dialogue and no warning.”
Disability Services Minister Hannah Beazley said the WA Government is working with the Commonwealth and the NDIA to find a pricing solution that meets the unique needs of regional Australia.
In the meantime, providers like Ms Lowe and Ms Breheny are left weighing impossible choices — whether to charge vulnerable clients out of pocket or shut their doors entirely.
“We’ve always worked with the belief that every person deserves access to care,” Ms Lowe said. “This puts that belief and the future of disability support in real danger.”
