I recently wrote to The Hon Mark Butler MP, my local Member of Parliament and Minister for Health, Disability and the NDIS, to express my deep concerns about recent changes to the scheme that are significantly impacting people with disabilities and the service providers who support us. I believe we may have met several years ago at a community event, and I appreciated the opportunity to discuss disability issues with him then. As my local MP and now as Minister, I felt it important to reach out directly to share my concerns and those of many others in our community.

Overview of Concerns

In my letter, I raised several critical issues affecting NDIS participants: the underpayment of therapists leading to service shortages, cuts to travel funding impacting access to care, the rollback of mental health support within the NDIS framework, and the lack of adequate support for navigating legal appeals through the Administrative Review Tribunal (ART, formerly the Administrative Appeals Tribunal - AAT). These changes and systemic issues are creating significant barriers for people with disabilities, and I hope to discuss potential solutions.

Therapist Fees and Service Sustainability

I am particularly concerned about the grossly underpaid therapists working under the NDIS. The recent 2024-25 Annual Pricing Review has introduced pricing reforms that will significantly impact therapy services from July 1, 2025. These changes include slashing fees for psychologists in four states and territories, cutting hourly rates for other allied health providers, and halving travel reimbursements for all therapy services.

Most concerning is that therapy prices have been frozen for nearly six years without indexation, while the cost of delivering therapy has surged dramatically. During this period, wages have increased by 22%, rent and insurance costs have risen significantly, electricity costs have increased by 30%, and inflation has risen by 24.6%. Despite these increases in operating costs, therapy rates remain stagnant, creating an unsustainable situation for providers.

This situation is causing quality therapists to stop providing services under the NDIS, as they cannot afford to continue operating at these rates. For many of us who rely on these services, the impact is devastating. We are already seeing providers introduce gap fees, reduce outreach services, cut therapy programs, and in some cases, close entirely.

Transport and Travel Costs

The new pricing arrangements have also cut travel funding by 50%, which particularly affects those of us in regional areas and those who require home visits. For many participants, transport costs to reach therapists far exceed what it would cost to pay for therapists' travel expenses. This change effectively eliminates the viability of home visits, community outreach, and mobile care services that many of us depend on to access therapy in our homes and communities.

Mental Health Services

I am also deeply concerned about reports that mental health services are being pulled back from the NDIS and pushed into the mainstream system. This fails to recognize that many of us with disabilities experience mental health issues specifically because of our disabilities, not to mention the additional stress of constantly worrying whether the NDIS will continue to provide the level of support we need without having to fight for it.

I have recently realized that my mental wellbeing is suffering from years of dealing with disability issues, personal challenges such as physical limitations, and the constant ableism I face on a daily basis. I started seeing a psychologist, but on my low income, it is impossible to pay for it. Mental health is strongly interconnected with physical disability, and this connection needs to be acknowledged and supported within the NDIS framework.

Appeals and Legal Support

While I understand that the NDIS operates as an insurance-type scheme and that appeals must go through legal processes, I am gravely concerned about the lack of support provided to severely disabled people in navigating these appeals. The number of people fighting to get their NDIS supports back through the Administrative Review Tribunal (ART, formerly the Administrative Appeals Tribunal - AAT) has increased by more than 400% recently.

My Personal Experience with AAT/ART

I have personally experienced the challenges of navigating the AAT process. I had to go to the AAT to secure a piece of equipment that significantly helps with my functional ability. The equipment cost approximately $20,000, and after two years of bureaucratic obstacles, I was finally granted it. However, I estimate that the NDIA spent at least two or three times the cost of the equipment on lawyer fees and other reports to fight my case, only to have to pay for the equipment on top of that. This represents a clear waste of resources by the NDIA.

Moreover, the equipment I received will last a good ten years, whereas many of the alternatives the NDIA offered instead would have cost them $20,000 every 18 months. Throughout the process, the rebuttals from the NDIA, through their ever-changing lawyers, demonstrated a significant misunderstanding of my case, with new lawyers joining every few months and their stance repeatedly changing. The last statement of issues they provided was entirely incorrect on every point. Thankfully, it seemed a more senior person recognized the errors in their statement and granted the funding before we had to meet with the Tribunal again. I am now feeling much fitter and more confident in many of my transfers, in and out my bed and wheelchair, these days thanks to this equipment, but the ordeal should not have been so drawn out and costly for all involved.

Community legal centres funded to represent people with disabilities are at capacity and struggling to take on new clients. Disability advocacy services are stretched to their limits, with many closing their waiting lists and being forced to leave people in desperate need of support behind. The demand for independent disability advocacy services has increased significantly since the NDIS rollout, yet funding has not kept pace.

The Bigger Picture

These issues represent a fundamental departure from the original vision of the NDIS. The scheme was designed to empower people with disabilities by providing necessary supports to live independently and participate fully in society. However, the current trajectory is creating barriers rather than removing them and is placing enormous stress on both participants and service providers.

As Minister Butler stated when he was appointed, the government's commitment is to ensure "the NDIS fulfils what its intention was: that everyone has the best opportunity to contribute to Australian society and that people with a disability don't get left behind". I fear that the current changes are moving us away from this goal.