Regional Australia has once more been stumbled over then stamped on by Canberra in a clumsy process for cost savings for the NDIS.
Few are not arguing that the NDIS needs review and needs remediation in sections of expenditure, but in Regional Australia recent decisions have picked its eyes out, blinding it to crucial services especially in the realm of Allied Health.
Allied Health keeps health problems managed at home and not delivered to hospital. It is not the unregulated rort that has in recent years come to light in other sectors of the NDIS package. Allied Health is essential for maintaining a standard of care, essential for a standard of living in regional areas that remains at least in sight of the care expected in the capital cities.
In the New England the proposed changes mean the 55-year-old male with Motor Neuron Disease relying on highly skilled physiotherapists to travel from Tamworth to Gunnedah to deliver complex equipment to support continued safe mobility in the home and respiratory care will no longer have this service.
So where is the alternative for this patient? There is none except the public hospital system which in many regional towns is struggling to get a doctor let alone a physiotherapist.
In other areas the largesse of the NDIS continues unabated.
For example, Level 2 Support Coordination, in the new price guide can be around $100.14 per hour and Level 3 (Specialist Support Coordination) can be around $190.54 per hour. Support Coordination is more than the rate for a physiotherapist with a four-year university qualification and a regulatory body that upholds standards of practice.
The NDIA spent $46.3 million on legal fees in 2023–24 contesting NDIS participant appeals at the Administrative Appeals Tribunal (AAT). This figure excludes costs for non-legal staff involved in the process.
Take, for example, a situation where a participant’s NDIS plan lacks essential funding for therapy or equipment. The participant may first request an internal review. If that still doesn’t resolve the issue, the case can be escalated to the Administrative Review Tribunal (formerly the AAT). In 70% of these cases, the NDIA ultimately changed its decision after review. To put that into context, only approximately 10% of Social Services reviews result in a change of decision.
This highlights the staggering cost and inefficiency of the current system. Instead of spending tens of millions on legal disputes, we should be investing in fairer, more transparent decision-making processes and providing direct, timely support to people with debilitating disabilities.
The NDIS cost that is going unchecked is the provision of complex equipment. Providers have increased the prices of their equipment, such as raising the cost of a standing frame from $15,000 to $28,000 over a five-year period. The increase occurs without regulation and continues to rise by thousands of dollars each month. This can mean the difference between a child being able to walk in a playground with other kids or have to sit inside, so the equipment is essential, but the cost is off the chain.
The crux of the issue Allied Health Providers are immediately facing appears to be the assessment of costs by the Independent Pricing Committee which has given scant to no details on how they calculated the cost for an Allied Health provider to drive from Tamworth to Narrabri for the provision of a service in a house for which there is no alternative service. It is vastly different driving the 400km round trip from Tamworth than driving from Surrey Hills to Parramatta.
To date, the only justification providers have received from the NDIS for cutting travel costs is based on an undisclosed number of participants feedback claiming that ‘therapy travel costs are draining their funding faster than expected. The updated travel claiming rules encourage more efficient scheduling by providers and provide clear cost expectations for participants to help them get better value from their funding.’
These practitioners are the frontline in community health care to stop a sore on a leg turning into a required amputation with the massive cost that would otherwise incur on the public health sector.
In a nation that can find around 10 billion dollars, now billions more in the State Budget, to subsidise intermittent power for overseas proponents and domestic billionaires there are vastly more worthy causes.
No doubt, as it goes with most regional issues, Canberra will work on the tactic that if the problem doesn’t come down to Canberra, then the problem is parked away and ignored. However, this issue has heat and it is going to be heard.
On the first sitting of Federal Parliament, they are coming to attempt to get the proper hearing that they never had before these decisions were thrust on them. I and others such as Queensland Senator Susan McDonald and Member for Lyne, Alison Penfold will see if the hearing Regional Allied Health receives is comparable to the love and affection other items such as solar panels and wind turbines get in the alternate universe which is Canberra.
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