4 days ago
Concerns NDIS cuts to physiotherapy travel will impact regional and remote children with disability
Two-year-old Stephanie Haley has been an inpatient at nine different hospitals.
She has quadriplegia cerebral palsy, which affects her mobility and ability to communicate.
She currently eats and drinks through a tube and is non-verbal.
Until recently, she lived in regional Queensland and accessed services through telehealth.
But Stephanie's mother Priscilla Haley realised that to be able to join other kids her age in settings like day care, the young girl would need in-person care.
Ms Haley packed up her life, border collie and little Stephanie, and moved to Darwin.
In the Northern Territory capital, a physiotherapist can travel to Stephanie's day care and prescribe specialist equipment, like shoes with ankle-foot orthoses.
Now, the National Disability Insurance Agency (NDIA) has cut physiotherapists' travel funding by half, through the introduction of a cap on travel allowances.
Health providers have said that cap will mean more patients will have to travel to them or face higher bills for out-of-clinic care.
The Australian Physiotherapy Association has warned the cap will have a particularly big impact on NDIS participants in regional and remote areas.
"A lot of the NDIS providers aren't going to be able to travel to deliver their services, so it will mean that [participants] will have to come in to the bigger centres," the peak body's NT president Heather Malcolm said.
For Stephanie, the cuts mean her physiotherapist will be unable to adequately assess what mobility aid equipment she needs at day care.
"She's learning to walk beautifully in that walking frame … to push herself around in the firefly scooter, but not in day care because that equipment is not there," Ms Haley said.
For Maddy Evans, also in the NT, physiotherapy has been vital to supporting her son through severe speech and cognitive challenges.
She said Oscar, who has PTEN hamartoma tumour syndrome — a rare genetic disorder that has caused his brain to develop differently — would feel the impact of the cuts.
Before physiotherapy, the six-year-old was only able to use a specialised swing at the playground.
Now, he can climb up the slide and independently use stairs.
"It's basic play skills, like that, [that] he's gained over a few years by working with a physiotherapist," Ms Evans said.
Oscar's physiotherapist also supports him beyond physical movement, as the skills he learns allow him to communicate as a non-verbal child.
"When he's on the swing, he's actually able to tell us he wants more," Ms Evans said.
The upcoming changes will also standardise NDIS coverage rates for physiotherapists across all jurisdictions.
That will involve a $40 per hour reduction for providers in the NT, WA, SA and Tasmania and a $10 per hour drop in other jurisdictions.
Ms Evans said she was worried the cuts could drive physiotherapists out of the territory and leave Oscar with only shared in-clinic sessions.
"They've tried to bring other children in, in the past — he will panic and just try to leave the space," she said.
Physiotherapist Emily Jordan's NT practice Outreach Physiotherapy travels to about 150 clients across 10 Indigenous communities, which all have limited in-community care options, if any.
"There's a lot of trust and relationship-building to see great effects out there, which we have been doing for the past five years," she said.
But Ms Jordan said it was "going to be challenging" for the service to continue visiting remote patients under the new funding model.
In a statement, the NDIA said the changes would "encourage more efficient scheduling by providers".
"We heard from participants that excessive travel claims for therapy-related services are draining participants' plans faster than expected," an NDIA spokesperson said.
"The NDIA is committed to improving access to NDIS support for Australians living in more regional and remote areas, and is taking steps to address market gaps across Australia."
Ms Malcolm, from the Australian Physiotherapy Association's NT branch, said the effects of the changes would be felt across state and territory health systems.
"Medium to long-term, people are going to have more issues that mean they need to present to the emergency department and their care has gone from disability care to needing support within the health system," she said.
She said the association was calling on the federal government to step in and pause the pricing changes before they come into effect from July.
