for anyone curious

Submission to the Senate Standing Committee on Community Affairs

National Disability Insurance Scheme Amendment

(Securing the NDIS for Future Generations) Bill 2026

May 2026

1. Introduction

I make this submission as a person with a unique perspective as to the impact of the legislation before this inquiry: as an NDIS participant, as the child of an NDIS participant, and as an AHPRA-registered physiotherapist delivering therapy supports to NDIS participants across Newcastle, NSW. I have seen the impact of changes made to the scheme administration and legislation since 2018 when I first began working as a physiotherapist.

I have spent close to a decade providing physiotherapy for NDIS participants as capacity building support in a variety of clinical environments. More recently, I have been able to build a sole-practitioner clinic that supports the complex needs of autistic people and people with physical disabilities as a result of rheumatological diseases. I am a ‘lived experience clinician’: I bring both clinical expertise and personal understanding of the conditions I treat. I have a neurodevelopmental and physical disability. I have Autism Spectrum Disorder (Level 2), diagnosed as an adult despite displaying clear signs as a child. I also live with Ankylosing Spondylitis (AS), a degenerative spinal disease that causes the bones and joints of the pelvis and spine to progressively fuse together. I am currently before the Administrative Review Tribunal because the NDIA has disputed the permanence of my condition, and funding for lifelong supports.

The NDIS was intentionally designed as a social insurance model intended to serve every Australian: to provide insurance against the costs of support in the event of acquiring a significant disability, to provide information about and referrals to care and support options, and to provide individually tailored supports for people with significant and long-term disabilities. The proposed changes to the NDIS Act threaten not only my life as a participant, but the viability of the practice I have spent years building, and the futures of the clients I support.

The proposed changes to how Australians will be able to access the Scheme, how individualised supports will be determined, and the provision of unprecedented Ministerial powers, will drastically shift the Scheme away from its original intent. The proposed changes do not target fraud and waste, as the Minister has repeatedly stated they do. As a signatory to the United Nations Convention on the Rights of Persons with Disabilities (CRPD), Australia is obligated to align its domestic laws, policies, and practices to protect, promote, and ensure the full and equal enjoyment of all human rights by people with disabilities. If passed into law, these changes will cause significant harm to disabled Australians and our families.

Of the 4.4 million disabled people in Australia, 774,456 are active Scheme participants; 17% of disabled Australians. AIHW data from 2018 indicates that 32% of people with disability had severe or profound disability, meaning they always or sometimes needed assistance or supervision with self-care, mobility, and/or communication. The Scheme exists because this need is real, significant, and unevenly distributed. The proposed changes must be assessed against that reality.

The concerns raised in this submission are not abstract. They reflect the clinical reality of living with and treating conditions whose functional impact is inseparable from environment, context, and the supports that make participation possible. They are grounded in clinical evidence, established disability science, and the decisions of Federal Courts whose findings this Bill proposes to override. They are also grounded in nine years of clinical practice observing what adequate, well-targeted disability support enables, and what its absence costs.

In a March 2025 statement, the then Minister for Social Services and the NDIS, Amanda Rishworth, said:

“We’re reforming the NDIS to deliver better outcomes for people with disability and to be more responsive to individual needs, as well as enabling more consistent, fair and transparent decision making so that it continues to provide the reasonable and necessary supports that people need.”

The proposed reforms categorically will not deliver better outcomes. This submission addresses the proposed functional capacity definition and its departure from the accepted international framework; the impact of the proposed definition on specific populations including autistic people, people living with progressive degenerative conditions; the proposed treatment exhaustion requirement and its clinical and equitable implications; and the cumulative effect of these provisions when considered together with other proposed changes to access, planning, and funding.

2. The Proposed Definition of Functional Capacity

2.1 Background 

The NDIS Act has always required a person to prove an impairment impacts their functional capacity. The current accepted framework for understanding functional capacity in disability is the World Health Organisation’s International Classification of Functioning, Disability and Health (ICF), adopted in 2001.

Under the ICF, functional capacity is inherently contextual. Functioning is understood as an interaction between a person’s health condition, their environment, and their personal factors. Professor Treveor Parmeter, speaking at the 2001 launch, recognised that the disability community must be consulted on the applications of the ICF, including as part of the development of support needs instruments/assessments. 

In clinical practice across physiotherapy, occupational therapy, and rehabilitation medicine, functional capacity is assessed in context. It is understood as the ability to perform a task reliably, consistently, and safely, across the range of conditions a person ordinarily encounters. Not as peak performance under optimal or controlled conditions. 

2.2 The Proposed Definition 

The proposed Bill sets out the criteria to assess a person’s functional capacity, and defines functional capacity as a threshold of capability; this is the most consequential and most dangerous provision in the proposed legislation. Proposed subsection 9B(1) would define a person’s functional capacity as their ability to undertake an activity without assistance from other people, assistive technology, or modifications, and in a context that excludes, as far as possible, the impact of the person’s environmental and personal circumstances. The proposed legislation explicitly instructs assessors to strip away environmental context as far as possible, and treat capacity as if it exists in a vacuum. This is a radical departure from how functional capacity has been understood within the NDIS to date, and the accepted definition of functional capacity within disability research and clinical practice.  

The Bill proposes that the operational content of this definition applies to NDIS rules that do not yet exist, whose content has not been disclosed, and whose development has not involved meaningful community consultation. 

2.3 The Definition as a Fiscal Instrument

The Bill was introduced alongside a stated government objective of reducing NDIS expenditure and constraining Scheme growth. The proposed definition is designed to systematically produce inflated functional capacity findings by way of equating capability with capacity, and use those findings to justify withholding access to supports that are necessary for a person to consistently and reliably complete daily living tasks, and live an ordinary life. 

A definition of functional capacity that strips away environmental and personal context, applied through a standardised assessment tool whose criteria have not yet been disclosed, restructures it to produce outcomes consistent with a fiscal objective. It is an explicit cost reduction, under the guise of neutral measurement methodology and clinical language. 

The Minister has repeatedly stated that these measures are intended to return the Scheme to its original intent of supporting Australians with ‘profound disability’. AIHW data from 2018 indicates that 32% of people with disability had severe or profound disability, meaning they always or sometimes needed assistance or supervision with self-care, mobility, and/or communication; 17% of disabled Australians are NDIS participants (People with Disability in Australia, Summary, 2024). 1 in 10 disabled Australians who need assistance do not have any access to assistance. Of those who have access to formal support, 35% have an unmet need for assistance, either needing more or needing assistance and not in receipt of any (Australian Institute of Health and Welfare, 2023). The proposed changes will significantly increase the number of disabled people who cannot access support, and those with an unmet need for formal support. Considering data from the Government’s own agency, the Scheme is objectively not serving or supporting all Australians with severe or profound disability.  

2.4 Clinical Critique 

Functional capacity cannot be adequately or accurately assessed without consideration of the environment in which a person operates and the supports they require to complete a task reliably, consistently, and safely. Under accepted practice, a person who uses a wheelchair has the functional capacity to move around, the chair is part of their functioning. The proposed definition would assess them as if the chair didn't exist. 

The proposed definition is at its core a legally constructed concept designed to establish need for funding by identifying baseline impairment. The accepted clinical and scientific definition treats functional capacity as dynamic, contextual and biopsychosocial. A definition that instructs assessors to exclude environmental and personal circumstances does not narrow that gap. The gap between what the definition measures and what a person actually needs does not disappear because the definition refuses to look at it. It makes it invisible, and then uses its invisibility to justify withholding the supports that would close it. 

A person may be able to perform a task once, under observation, in a controlled setting. That performance is not functional capacity in any clinically meaningful sense. It is a snapshot of peak performance under artificial conditions that bear no relationship to the context in which that person must live their life every day. The purpose of a functional capacity assessment is to measure how much support a person needs to live an ordinary life, and complete a task reliably, consistently, and safely. The same ordinary life that someone of the same age, life stage, educational background, and employment aspirations would take for granted. It is a measure of the gap between where a person is and where they could be with the right support. 

The existing NDIS framework acknowledges that functional capacity is highly individualised. The proposed definition discards that principle in favour of a decontextualised snapshot that will systematically undercount the support needs of people with fluctuating, environment-sensitive, or progressive conditions. The Government, by way of these proposed changes, is actively working to exclude a very large proportion of current NDIS participants.

2.5 Impact on Specific Populations 

2.5.1 Ankylosing Spondylitis (AS)

Ankylosing spondylitis is a progressive inflammatory condition whose functional impact fluctuates significantly with disease activity, fatigue load, prior exertion, temperature, and time of day. Morning stiffness is a defining clinical feature of AS. On a bad day, I can experience up to 3 hours of morning stiffness. This feels like my bones and joints are set in concrete, and I am trying to move through mud. A person assessed in the afternoon following a period of rest may present with substantially different functional capacity than the same person would at 7am after a poor night's sleep or during a flare. The proposed definition, by seeking to strip away environmental and personal context, cannot account for this variability. 

I am an ambulatory wheelchair user; the physical environment I move through directly determines what I can and cannot do on any given day. Whether I can complete a task depends on the surface, the distance, whether I am in a flare, and what I have already expended that day. But the relationship between environment and capacity runs deeper than that. If I cannot work, I cannot afford to rent an accessible home. If my home is not accessible to me as a wheelchair user, I am more disabled by my environment than I would otherwise be. My disability and my environment are not separate variables that can be isolated from one another for the purposes of a clean assessment. They are interdependent.

An assessment that captures performance in a controlled setting will inevitably overestimate the functional capacity of people with AS across the full range of their daily lives. As the disease progresses, a person's ability to perform daily living tasks declines in a stepwise manner. The question that matters, can this person perform this task reliably, consistently, and safely across the course of an ordinary week, is precisely the question the proposed definition is designed not to ask.

2.5.2 Autism Spectrum Disorder

Autistic people have been heavily targeted by the media as the ‘dole bludgers’ of the NDIS; approximately 35% of NDIS participants have their primary disability listed as Autism Spectrum Disorder (Autism | NDIS, 2023). For autistic people, functional capacity is inseparable from the environment. The ability to communicate, self-regulate, and participate in daily activities is directly shaped by sensory demands, environmental predictability, the familiarity of surroundings, and the presence of established support structures. The proposed definition would produce assessments that reflect capacity to perform under conditions of deliberate deprivation, not capacity to participate in ordinary life. For autistic people with high support needs who have built functioning lives through years of capacity building, environment modification, and therapeutic support, this definition threatens to render that investment invisible at the point of assessment. 

An autistic person assessed in an unfamiliar clinical setting, without their routine, their communication supports, or their sensory accommodations, will present as a fundamentally different person. Not because their underlying impairment has changed, but because the scaffolding that makes their function possible has been deliberately removed.

My autism means I require high levels of support to effectively communicate, and manage the demands of unfamiliar environments. Without familiar relational and environmental supports in place, I am unable to function in a manner that reflects my intelligence nor the years spent engaged in capacity building therapies. An assessment that removes those supports, for the purpose of understanding my “functional capacity” is a direct breach of the obligations of a government agency under the CRPD.

2.6 Delegation and Transparency Concerns

The Bill delegates the operational content of the functional capacity definition to NDIS Rules that do not yet exist, whose content has not been disclosed, and whose development has not involved meaningful community consultation. The Committee is being asked to legislate a framework without knowing what it will require in practice. Participants cannot assess the impact of provisions whose content has not been written.

This is a significant procedural concern. The definition as drafted establishes the legal architecture for a standardised assessment tool. The criteria for that tool, the classifications it will apply, and the thresholds it will set are all to be determined by Rules made after the Bill passes. The community, including public sector staffers who will be required to apply these tools, cannot meaningfully respond to a framework whose content has been withheld.

3. Proposed Changes to the Definition of Permanence

3.1 Overview

In physiotherapy clinical practice, a permanent condition is understood to be any long-term or lifelong condition that is unlikely to fully resolve or be cured. The Bill proposes several changes that would prevent people from accessing the NDIS where treatments exist that could improve or reduce the effect of their impairment. The proposed legislative changes would substitute a clinically grounded understanding of permanence with a bureaucratic one that serves neither participants nor the original intent of the NDIS.

These provisions raise serious concerns about equity of access, bodily autonomy, and the coherent operation of the Scheme, and would have disproportionate impacts on people with progressive, fluctuating, and treatment-resistant conditions.

3.2 Treatability Is Not Equivalent to Reduced Support Need

The proposed treatment exhaustion requirement conflates two distinct questions: whether a condition is treatable, and whether treatment reduces a person’s need for disability support. In any other context these are not considered to be the same question. The Bill does not adequately distinguish between them. Treatment may stabilise a condition, slow its progression, or partially alleviate specific symptoms, and substantial functional impairment remains. 

Requiring a person to demonstrate they have exhausted all appropriate treatment before accessing the NDIS risks excluding people who are actively and successfully engaged with their treatment and still profoundly disabled. Where ‘appropriate’ is defined only as evidence-based, potentially improvement-producing, and regularly performed in Australia. If the changes are implemented, the NDIS will be the only government system whereby a person's individual circumstances will be explicitly excluded from the contextual understanding of an accessible appropriate treatment. 

3.3 Impact to My Circumstances

3.3.1 Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is, by any clinical or common-sense definition, a permanent condition. It is degenerative, progressive, and without cure. Acquiring a significant disability can occur in spite of active medical treatment for a progressive degenerative condition. I am already before the Tribunal because the NDIA has disputed the permanence of my condition, notwithstanding that it is a degenerative, progressive, and incurable condition.

I am significantly concerned by the potential application of ‘all appropriate treatment’ as a benchmark by which impairment permanence is measured. The NDIA's existing approach to my condition suggests the Agency may take an expansive view of what 'available treatment' means. 

The Agency’s position in regards to AS and treatment was stated as:

“Although AS/axial spondyloarthropathy can be chronic, the evidence indicates ongoing active medical treatment (including biologic therapy) directed to symptom control and functional improvement and does not adequately address whether any AS-attributable functional limitations are likely to be permanent notwithstanding treatment.”

This reasoning reflects a fundamental misunderstanding of how progressive conditions interact with treatment. The NDIA’s position appears to be that because biologic therapy is available and active, the permanence of functional limitation cannot be established. This conflates the existence of treatment with the restoration of function. They are not the same thing.

Biologic therapy has materially reduced inflammation and slowed structural disease progression. What it cannot do is reverse existing damage, restore lost mobility, or eliminate the fatigue, pain, and functional limitations that accumulated over the course of time that the disease was undiagnosed and untreated. I have responded well to biologic therapy. I am still unable to work full-time, maintain a home independently, or sustain activity across a full day. I will not regain the ability to walk far enough to manage daily living and employment, safely or reliably, notwithstanding treatment. 

This is what AS progression looks like in practice. It is happening to me while I comply fully with my treatment regimen. If the NDIA’s permanence criterion cannot accommodate this reality, the criterion is not fit for purpose. If the proposed Bill entrenches or extends that criterion, it will replicate my situation across a substantial cohort of participants with progressive conditions, making disputes like mine far more common and far harder to resolve.

A definition of permanence that excludes people whose conditions are actively progressing, whose function is measurably declining, and who are wheelchair-dependent despite treatment, is not a workable definition. It is a barrier to the Scheme’s own purpose. The question of permanence should not be whether treatment is available or active. It should be whether, on the best available evidence, the functional limitations arising from the condition are likely to persist regardless of treatment. For AS, the answer is yes. This is the clinical consensus. It is also what my own circumstances demonstrate.

3.3.2 Autism Spectrum Disorder

ASD is a neurodevelopmental condition. There is no cure, and no treatment that changes the underlying neurobiology. Any definition of permanence that requires participants to have exhausted treatment options before accessing the NDIS would be applied to ASD in a deeply misleading way. The relevant question is not whether ASD can be treated, but whether it causes functional impairment that the NDIS exists to address.  As a late-diagnosed adult, I am aware that I have the appearance of functioning: I hold a university degree, I run a business, I have the capability to speak in full sentences. Appearances are deceiving.

The proposed treatment exhaustion requirement, combined with its application to early intervention under proposed subsection 25(1B), raises particular concerns for autistic children and their families. Early intervention for autism is time-sensitive. The neuroplasticity that makes early intervention effective is greatest in the first years of life. Requiring families to demonstrate treatment exhaustion before accessing early intervention supports does not merely delay access. It eliminates the window in which early intervention produces meaningful outcomes. The Bill’s own explanatory material acknowledges that early intervention is intended to help people get support sooner and reduce long-term costs. Applying the treatment exhaustion requirement to early intervention directly contradicts that objective.

In the seven months I spent waiting to access the NDIS in 2024, I experienced severe Autistic Burnout. I lost employment. I became severely socially isolated. I experienced suicidal ideation. It was the most suicidal I have ever been in my adult life. Suicide deaths account for 6.0% of all deaths among people with a primary disability of autism, the second highest proportion across all primary disability types, according to the Australian Institute of Health and Welfare's suicide and self-harm monitoring data (Mortality Patterns among People Using Disability Support Services: 1 July 2013 to June 2018, Summary, 2020). Autistic people have been found to have up to an eightfold increased risk of death by suicide compared to non-autistic people, with co-occurring mental health conditions, social isolation, and lack of support identified as key risk factors (Brown et al., 2024).  

With access to NDIS supports for my ASD, I have not experienced any suicidal ideation since Spetember 2024. Disability-specific support for autistic people is suicide prevention. The seven months I spent without it nearly killed me. This must be understood as a safety issue, not merely a quality-of-life one. Any barrier to access to NDIS supports for autistic Australians carries a measurable risk of harm that the government cannot credibly ignore. 

There is no treatment that would make my ASD 'resolved' or ‘cured’ in any meaningful sense. Any definition of permanence that requires participants to have exhausted treatment options before accessing the NDIS would be applied to ASD in a deeply misleading way, given that the relevant question is not whether ASD can be treated, but whether it causes functional impairment that the NDIS exists to address. The answer, in my case and for many others, is clearly yes. 

3.4 The Reversal of Davis and Structural Inequity

The Bill proposes to reverse the Federal Court’s decision in NDIA v Davis [2022] FCA 1002 (‘Davis’), a deeply alarming action taken to limit access to a scheme that enables access to life-changing support. The Court in Davis recognised a principle that reflects clinical and social reality: that a treatment being theoretically available is not the same as a person being able to access it. There are many legitimate reasons why an evidence-based treatment may not have been trialled: it may be unaffordable, geographically inaccessible, clinically contraindicated given the person's broader health status, or previously attempted and abandoned due to adverse effects. None of these circumstances reflect a failure of compliance on the part of the person with disability. They reflect the realities of living with a serious condition in a healthcare system with significant access inequities. To reverse Davis is to hold people responsible for those inequities, and to make NDIS access contingent not on the nature of a person's disability but on their postcode and their income. This fundamentally is incongruent with the original intent of the NDIS as set out by the Productivity Commission. 

The proposed reversal of this position would reintroduce a structural inequity that the Davis decision addresses. Under the proposed change, two people with identical impairments and identical functional capacity could receive different access outcomes depending on whether they can afford treatment or live within reach of a provider. A person in regional Australia without access to a specialist, or a person who cannot meet the out-of-pocket costs of ongoing treatment, would be treated differently from a person with the same diagnosis and the same disability who happens to live near a major hospital and hold private health insurance. This is not a principled distinction. It is an accident of circumstance that the proposed legislation would elevate into a legal threshold for NDIS access.

3.5 Bodily Autonomy

The proposed provisions would exclude from NDIS access people who decline treatment for non-medical reasons. This conflicts with a foundational principle of Australian medical law. The right to refuse medical treatment, including treatment that is clinically available, is recognised at common law and enshrined in the informed consent doctrine. A person may decline treatment because of its side effect profile, because of prior adverse experience, because it conflicts with their cultural or religious values, or because the burden of treatment is not one they are willing or able to bear. These are legally and ethically protected decisions. 

The NDIA is not a treating clinician. A treatment being ‘available’ does not make it clinically safe or appropriate; the NDIA should not have a say in the medical care of disabled people, in order to “return the scheme to its original intent”. It should not be placed in a position where it can, in effect, require a person to undergo medical treatment as a condition of accessing disability support. Conditioning access to disability support on compliance with treatment decisions removes that protection in practice, even if not in name. This is not consistent with the rights of disabled Australians under Australian law or under Australia’s obligations under the UN Convention on the Rights of Persons with Disabilities.

4. Proposed Changes to the Legal Test for Supports

4.1 A Fundamental Framework Shift

The NDIS was intended to be a supplementary support to existing support programs. The proposed Bill fundamentally reorients the Scheme away from individual need and toward financial sustainability as a primary decision-making criterion. For people with progressive, degenerative conditions, this reorientation is a foreseeably harmful policy that will accelerate deterioration, increase long-term costs across the health and social services system, and withdraw the supports that enable people with disability to live independent, contributing lives.

The legislative response proposed in this Bill suppresses the quality of decision making, and abandons the ‘whole of person’ approach to funding supports that was secured in the 2024 amendments to the Act. These proposed changes to supports include funding only supports that arise directly from impairments meeting the access criteria, recognising the role of community and informal supports, and distributing funding ‘fairly and consistently’ across participants with similar needs. Each of these principles, in isolation, may appear reasonable. Together, and applied to participants with progressive conditions, they produce outcomes that are clinically indefensible. 

4.2 Changing Objects and Principles

The proposed Bill removes section 31, substituting the reference to ‘reasonable and necessary supports’ with ‘NDIS supports consistent with the financial sustainability of the Scheme’. Removing in whole the principle of ‘reasonable and necessary supports’ to shift the focus of decision making towards the financial sustainability of the Scheme is in direct opposition to the original intent of the NDIS: to provide individually tailored supports for people with significant and long-term disabilities. Under the current Act, objects and principles have anchored decision-making to individual circumstances, personal goals, and choice and control. While the objects and principles of the Act have not guaranteed particular outcomes, they have provided a framework under which planning decisions should be based on individual circumstances, personal goals, choice and control, with plans shaped by participants.

Courts and tribunals have used those provisions to guide outcomes as to how the Scheme should be applied. When a court applies an evidence-informed, individual-needs framework and reaches an evidence-informed conclusion in favour of a participant, that is the system functioning as intended. The proper, and commonsense, application of whole of person assessment of support needs was confirmed in the case of CEO of the NDIA v Eastham [2026] FCA 147 (‘Eastham’). Undoing this approach will impose artificial distinctions in the way a person with multiple and interrelated disabilities is able to access supports. The Minister has justified this on the basis that current objects and principles have led courts and tribunals to favour participants. Courts favouring participants in a scheme designed to support participants is not evidence of unintended expansion. It is evidence that the legal framework was working as intended.

The impact of this legislative response is not abstract to me. I am a person who lives with distinct yet interrelated disabilities. A test of ‘directly arising’ impairments would involve questions of judgement about complex areas of a person’s life. While the impairments that arise from Autism and AS are distinct, the interaction of my disabilities amplifies the impairments and limitations that would exist in the absence of one or the other. Reasonable and necessary supports for my AS will not address support needs due to Autism; the collective impairments must be considered in order for the totality of my disability needs to be supported.

4.3 Consistent Treatment Across Similar Needs

New section 17B includes a principle requiring funding to be distributed ‘fairly and consistently’ across participants with similar needs. This principle deserves specific scrutiny. 

Participants with progressive conditions are not similarly situated to participants with stable conditions, even where their current functional presentations may appear comparable. A person whose condition is degenerative will require greater and more intensive support over time. A person whose condition is stable will not. Treating them as equivalent for funding purposes is the application of a superficially equal standard to an unequal situation, which produces inequitable outcomes.

Appropriate support cannot and should not be determined solely on the basis of the perception of ‘similar need’ as determined by a yet undefined and untested tool, that removes any consideration of personal and environmental context will artificially deflate the support needs of people living with progressive and degenerative conditions.

4.3.1 The Paradox of Appropriate Support 

Ankylosing Spondylitis is a progressive, inflammatory arthritis that primarily affects the spine and sacroiliac joints. In the absence of ongoing management and maintenance therapies, it causes the vertebrae to fuse, resulting in permanent loss of spinal mobility and, frequently, significant respiratory compromise as chest expansion becomes restricted.

I am currently 33 years old. The allied health and daily living supports I require to maintain function now will not decrease as I age. They will increase, becoming more frequent, more intensive, and requiring more highly skilled support. A plan that treats my support needs as stable is not a neutral administrative decision. It will cause harm that is measurable, predictable, and preventable. It will increase future dependence on more intensive and costly supports across the health and social services system. It will accelerate my deterioration, and punish me for having a degenerative condition that will be described as a financial burden to the Scheme.

4.4 The Fiscal Incoherence of Limiting Supports Funding

The Bill introduces new mechanisms that empower the Minister to limit how much funding participants can use for particular supports, even where such supports are deemed reasonable and necessary. The Minister’s stated justification for the Bill is long-term sustainability. These proposed cuts and proposed maximum caps to supports funding are inconsistent with that goal, and the guiding principle that the benefits of the NDIS would significantly exceed the costs.

Conservative estimates suggest that for every dollar invested in the NDIS, $2.25 is returned in economic activity (The Economic Benefits of the National Disability Insurance Scheme and the Consequences of Government Cost-Cutting - AFDO, 2021). In 2020-21 the NDIS alone contributed approximately $52.4 billion to the economy. By positioning these changes to support funding as ‘cost saving measures’, the Government is willfully ignoring the return on investment through economic participation of participants and their family members, allied health professionals, support workers, and public servants.

The NDIS acts as a massive driver of service-sector employment and value generation. Any cuts to the scheme are highly correlated with broader economic contractions. For every $1 billion the Scheme is underfunded, modelling indicates a loss of approximately 10,200 jobs, total GDP contraction of 0.14%, and a decline in total economic activity of $2.25 billion (An Analysis by per Capita for National Disability Services for the Teamwork Works Campaign FALSE ECONOMY, 2021). These are direct, predictable economic costs of treating the NDIS as a line item to be reduced rather than an investment to be protected.

Beyond the macroeconomic picture, limiting supports funding will have a direct impact on workforce participation by people with disability. The Scheme has, over time, increased the rate of disabled people in paid employment, while simultaneously freeing thousands of informal carers, predominantly women, to return to the workforce. In 2018, 48% of Australians with disability aged 15–64 were in employment (Australian Institute of Health and Welfare, 2020). Employment is not only an economic contribution; it is bound to physical and mental health, social connection, and long-term reduced reliance on government support across all systems. 

4.4.1 Supports Limitations as Gender-Based Discrimination 

The burden of underfunding will not be distributed evenly. It will land, as it always does, predominantly on women; seven in ten carers in Australia are women (Workplace Gender Equality Agency, 2022). Australian carers already provide 2.2 billion hours of unpaid informal care each year, valued at $77.9 billion if replaced by paid services. The decision to limit NDIS supports funding is a decision to transfer the cost of disability support from the public purse onto the shoulders of women who are already carrying a disproportionate share of Australia's unpaid caring burden.

Research consistently shows that female carers face lower rates of labour force participation, reduced income, and compounding economic disadvantage as a direct consequence of their caring responsibilities (Workplace Gender Equality Agency, 2022). A government that claims to be advancing gender equality cannot simultaneously design policy that will deepen it. The Committee should name this for what it is.

4.4.2 Capacity Building Supports, the Mechanism of the Scheme

Capacity building is the mechanism by which the NDIS delivers on its foundational promise: that investment in people with disability today reduces the need for more intensive support tomorrow. The NDIS exists so that Australians with disability can live an ordinary life. The same kind of life that Australians without disability take for granted. The current trajectory, where the Agency views decreasing support needs as the benchmark of a well-functioning plan, is clinically incoherent when applied to progressive conditions. For AS, and similar degenerative conditions, support needs increase as disease progresses. A framework that penalises participants for this reality by reducing their plans does not promote sustainability. It produces predictable harm.

In my clinical work as a physiotherapist over the past twelve months, I have witnessed essential capacity building therapy budgets slashed in participant plans despite clear clinical evidence that any reduction in therapy constitutes a real and significant risk of deterioration.These are essential supports that enable participants to maintain function and prevent deterioration; to build independence and reduce reliance on paid support workers; and to participate in their communities and, where possible, in employment, by slashed from participant plans despite evidence provided that any change to a therapy budget constitutes a real and significant risk.

4.4.3 The Role of Funded Supports in My Life

The investment the NDIS has made in my capacity has returned something that cannot be reduced to a line item. It has returned an ordinary life, the life the Scheme exists to make possible.

The things my social and community supports make possible are ordinary. They are essential. And they would disappear without NDIS funding. Attending pilates to maintain my spinal mobility and build connections in my community. Going grocery shopping, and going out for a coffee. Attending conferences and seminars for work. Spending time with my family, and being present at the events that matter to them. 

Without my social and community supports, I cannot go to the grocery store. I cannot maintain the routines that allow me to work. I do not leave my home. My ASD creates profound sensory and navigational challenges in unfamiliar or unpredictable environments. Social and community supports have reduced my isolation, supported my mental health, and built the kinds of peer relationships and community connections that no clinical setting can replicate. Daily living supports ensure that I am safe and clean. Together, they allow me to live a connected and independent life. 

Without supports for my ASD, I would not have been able to continue living independently. I would not have been able to navigate employment, let alone build and sustain a small business. The executive function demands of self-employment require structured, supported strategies developed through capacity building therapy. Without that foundation, those tasks are unmanageable.

Without recognition of, and fully funded supports for my AS, I will not be able to maintain the physical function necessary to work at all. That is a loss of a person in the workforce, paying taxes, contributing professionally to their community, and materially reducing their long-term reliance on government support across every system, not only the NDIS. 

The proposed cuts and caps to capacity building supports will have devastating consequences, for me personally, and for the clients I support as a physiotherapist. All participants deserve access to early intervention physiotherapy support. Ensuring that people with disabilities achieve the highest level of function, independence and mobility possible must be considered to represent value for money by reducing the likelihood of escalation to higher-cost supports. For Australians with disability, access to physiotherapy services means access to clinicians who are highly skilled in the diagnosis, assessment and treatment of motor impairments and movement disorders, including the sensory, musculoskeletal and neurological contributors. Without access to appropriate and timely physiotherapy support, participant safety and independence is significantly reduced. This will inevitably lead to escalation in care and support needs, increased NDIS cost.

4.5. Other available Supports Systems

There is no other support system that reasonably meets the needs of disabled Australians. The NDIS was always intended to fully fund specialist disability supports, including social and community access.The NDIS was intentionally designed as a social insurance model intended to serve every Australian: to provide insurance against the costs of support in the event of acquiring a significant disability; to provide information about and referrals to care and support options; and to provide individually tailored supports for people with significant and long-term disabilities.

State and Commonwealth healthcare services are not designed to support or fund disability-related needs. These services provide short-term clinical treatment and cannot provide the ongoing daily living, environmental support, or long-term capacity building therapy supports that promote the economic participation of participants.

Medicare schemes, including the Chronic Disease Management Plan, provide a very limited number of allied health sessions per year (typically 5–10 sessions), which is wholly insufficient for long-term disability needs. These sessions are time-limited, condition-specific, and not structured to deliver the sustained, relationship-based therapeutic support that people with permanent and significant disabilities require. To characterise these schemes as adequate or as meaningful supplements to NDIS-funded supports reflects a fundamental misunderstanding of the original intent of the Scheme, the clinical realities of disability, and the evidence base underpinning the NDIS model.

5. What the NDIS Means to Me

The NDIS means that disabled people are able to access therapies, daily living support, and assistive technology that otherwise would have forced them into poverty. The NDIS means that I am able to provide physiotherapy care to people with a variety of disabilities, in whatever setting or environment suits that person best, and maintain a work environment that allows me to continue to be able to work in my chosen field. The NDIS means I am able to live independently, I am not reliant on my family or a partner, able to work in a manner that sustains my capacity, and access supports that mean I am able to safely participate in society. 

The NDIS is supposed to mean that people with disabilities are able to participate in society, in spite of the social barriers that would otherwise bar their inclusion.

I see the impact of the NDIS everyday. In my work, I see what it means for someone to move around their home independently with the confidence that they will not fall. I have worked with people after a stroke, who believed they would never feel safe holding their grandchild again. With NDIS funded therapy supports, they have been able to have the supervision needed to retrain their body, and access to assistive technology, to feel confident to hold their grandchild. As a lived experience clinician, who both provides and receives disability support, I understand what ongoing therapy means for a disabled person's ability to live a safe and healthy life in a way that shapes every clinical decision I make.

The NDIS means I am able to live independently, work for myself, and maintain friendships. It has meant I can continue living independently even during periods when I have been extremely unwell and unable to leave my home safely. Without it, I would not have been able to remain in Newcastle. I would not have been able to work in the field I spent almost a decade studying for and building a niche in. The scheme has made my life possible.

My social and community supports allow me to do things that most people take for granted: go to the grocery store, attend pilates to maintain my mobility, visit my family. My ASD means that new and unfamiliar environments are profoundly stressful — what feels routine to a neurotypical person requires the equivalent cognitive and emotional effort that a non-autistic person might expend reading a difficult academic paper. It feels foreign. It takes enormous, sustained effort. At the same time, my AS means I am physically unable to lift or carry anything heavier than three kilograms without a support person. Without supports, I do not leave my home.

My capacity building supports have allowed me to maintain the physical function I have left, develop strategies for navigating daily life as a late-diagnosed autistic adult, and remain in the workforce as a health professional. Without them, I would not have the independence I have now, and I would have far less of it in the future.

The NDIS means I am not forced into poverty to access the assistive technology and devices that allow me to leave my home safely, maintain my health and wellbeing, build and sustain friendships, and continue to work in my chosen field. For many disabled Australians, the alternative to the NDIS is poverty, isolation, and dependence on a family network that was never designed to bear that weight alone.

6. Lack of Clarity and Inadequate Consultation

I am terrified by these proposed changes. I say that not for effect, but because it is the most accurate description of my emotional state. The uncertainty about what these changes mean, how they will be implemented, and when they will take effect has caused me significant distress that compounds the already considerable burden of managing two serious conditions and running a small business.

I am a university-educated health professional. I have read the proposed legislation and the accompanying materials carefully. I still do not fully understand what these changes mean for me as a participant. I do not understand what they mean for me as a provider. If someone with my background and motivation cannot parse the implications of these changes, the government cannot claim it has communicated them clearly.

The NDIS was built on the principle of ‘nothing about us without us.’ This Bill, and the process by which it has been developed, falls well short of that standard. The disability community has not had adequate time, access, or information to engage meaningfully with what is being proposed.

7. Recommendations

I respectfully ask the Committee to:

• Reject or substantially amend the proposed changes to the permanence definition. Eligibility must be based on functional need, not on a participant’s ability to access or afford treatments that are not standard care, not available locally, or not financially accessible.

• Reject the proposed changes to the functional capacity definition. Functional capacity cannot be adequately or accurately assessed without consideration to the environment and the supports an individual needs to complete a task reliably, consistently, and safely. 

• Protect capacity building supports, including allied health therapy. These supports deliver measurable long-term savings and are, for many participants, the difference between independence and institutional care.

• Preserve social and community participation supports as essential components of a participant’s life and of the scheme’s purpose.

• Require genuine, extended, and accessible consultation with the disability community before this legislation proceeds further. The current process has not met the standard the NDIS was built on.

The NDIS has made my independent life possible. It has made my career possible. It has allowed me to contribute to my community and to the people I support. I am asking the Committee to ensure that this legislation does not take that away from me, from my family, or from the clients who depend on me to advocate for them.

Submitted by: Bess Stewart

Occupation: Physiotherapist / NDIS Participant / Family Member of NDIS Participant

Location: Newcastle, NSW

Date: 31 May 2026

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