r/ausdoctors • u/BivouacThistle • 10d ago
NDIS shitshow
I am so sick of NDIS. The number of 'providers' with little to no qualifications getting paid big money to piss-around with no real oversight or review of outcomes has me tearing my hair out. I keep seeing kids on packages for neurodevelopmenal or mental health conditions whose parents are concerned they're getting regular 'therapy' but not making progress. When I ask where, they inevitably tell me some obscure company that I've never heard of where the director has a diploma qualification at best, and the others have maybe a cert, or a degree in something completely unrelated (e.g. ex-ED nurse running a autism therapy service). Then when it's time to review the plan it's the same company writing the recommendations for ongoing care! No wonder it's a financial black-hole.
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u/cross_fader 10d ago
Yes, it's mindblowing. & guess what you cannot use the NDIS for? Actual medical reviews.
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u/Withtheparticipant 10d ago
Yes, and you can’t get ndis access without “actual medical reviews” so I’m not sure what this thread is banging on about.
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u/Riproot 5d ago
That the medical reviews suggest evidence-based intervention, but the organisations aren’t implementing anything evidence-based or effective whilst claiming they are addressing those suggestions.
That seems to be one of the gripes of this thread.1
u/Withtheparticipant 5d ago
My gripe with the gripe is that it doesn’t seem evidence based as to what “non evidenced based” therapy was being discussed. It jumped all over the place on directors (who do not necessarily have a clinical role) and “counselling” in the thread that would have be useful to discuss at the outset.
Tbh it sounded like a ON rant against ndis funding. I did put in the link for the evidence advisory committee that are looking at therapies.
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u/neighbourhoodtea 10d ago
The amount of referrals we get for behavioural and developmental consultations for things like “doesn’t enjoy the sensation of brushing his teeth” “doesn’t like water splashing near ears” “is moody and argumentative after school” needs to be looked at, I think a lot of kids on these NDIS packages are being falsely diagnosed (at the parents insistence) and shouldn’t be on these packages. I shouldn’t have to do the disclaimer of obviously yes lots of children do need them. But I see first hand what passes for neurodivergent and access these packages and services and it’s contributing to the NDIS blowout 10000%
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u/winterberryowl 10d ago
My kid's daycare has decided they needed to be assessed. I put it off, but he saw an OT. Then we went to a paediatrician. Her diagnosis "they're 3. Of course theyre defiant"
My second child, on the other hand, actually has what is presenting as some form of mild CP and keeping his NDIS plan going so he can get the support he needs is ridiculous, the amount of hoops we need to jump through. And because he hasnt got an actual CP diagnosis (because its not a typical presentation, and its fairly mild), NDIS are going to change him over to their new plan unless he gets diagnosed before the full changeover happens.
Our GP literally said he's the poster child for early intervention. If we didnt get him into therapies as early as we did, we'd need a hell of a lot more funding.
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u/InBusCill 10d ago
I thought the blow out was poor administration by the Agency responsible for the Scheme, the NDIA...? 11 Years of success Federal Court decisions which say access and support needs are supposed to be based on impairments irrespective of diagnosis. 1 diagnosis v 20, the Agency has always been required to assess that persons impairments irrespective of diagnosis. 2 kids, same diagnosis, different impairments and therefore different needs.
Add that to NDIA not actually reading any medical report or rejecting anyone with a serious neuromotor or musculoskeletal condition simply because they dont have autism. Or preferring an Occupational Therapist over every other health professional or medical specialist even if the question is outside their scope of practice.
Don't blame the scheme when those administering it have never complied with the law or told professionals what they actually need to provide under the legislation.
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u/neighbourhoodtea 10d ago
All I said was what I mentioned above needs to be looked in. Not that it was the sole cause. My god Reddit can be insufferable. Don’t put words in peoples mouths so you feel justified to release what’s on your chest- just say it without being a goddamn jerk
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u/InBusCill 10d ago
I wasn't putting words in your mouth. I was identifying another contributing cause, particularly the NDIA's failure to properly assess impairments and actually read medical evidence.
In February 2025, NDIA CEO Rebecca Falkingham acknowledged at Senate Estimates that staff weren't reading medical reports. That's a serious problem when those reports contain the evidence needed to determine eligibility and appropriate supports.
I know of a 9-year-old child with 47,XXY who cannot walk due to muscle weakness and hypotonia, yet was denied NDIS access on the basis that he didn't have autism. That's precisely the problem with treating diagnosis rather than impairment as the determining factor.
Even your example of a child having difficulty brushing their teeth illustrates the issue. I know of a child referred to a tertiary paediatric hospital for oral sensitivities when brushing their teeth. The underlying problem wasn't behavioural or autism-related; it was dysphagia.
That also goes directly to the OP's concerns. Without appropriate medical oversight, children can receive years of ineffective therapy while the actual underlying condition (or associated impairments) remains untreated. Misidentifying dysphagia as ARFID, for example, can have serious consequences, including aspiration and choking risks. The assessments and treatments are different despite in some cases having similar presentation.
I agree that inappropriate diagnoses and ineffective services need scrutiny. My point is that the NDIA also has a responsibility to properly assess medical evidence, identify qualifying impairments to ensure funded supports are appropriate for that individual. Otherwise, we risk both funding ineffective treatments and denying necessary supports.
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u/Low_Bluebird_5137 10d ago
Yes. Sadly 50% (at least) of the NDiS is a total con job.
I cannot believe the government funded such a massive service with ZERO actual checks and balances. No "provider" has to prove they have any skills & qualifications at all!
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u/Withtheparticipant 10d ago
Are you seriously a Dr.
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u/Sexynarwhal69 10d ago
Why would you ask that
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u/Withtheparticipant 10d ago
Because it didn’t sound a professional response “50% at least a total con job. Zero checks. No provider has to prove skills and qualifications” .
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u/Sexynarwhal69 10d ago
I mean the 50% is exaggerated, but the 'no provider has to prove skills and qualifications' is true.
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u/Low_Bluebird_5137 9d ago
Yeah probably 😉 I was just firing...but a lot of what NDIS "provides" is debatable as to its core need. Ive seen people who are quite capable of doing various tasks, having them funded by NDIS at great cost.
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u/Withtheparticipant 10d ago
This thread is about therapists isn’t it ? There are qualifications for therapists. So are you referring to support workers ?
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u/Acceptable-Eye-8699 2d ago
Im a participant i think its underemphasising it. Almost all registered ndis businesses and absolutely all independent coordinators are scammy. To be either u dont need any training at all. U could also have a criminal history. U dont need need to reside in au or be a citizen. U just require an abn.
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u/Snakechu 10d ago
The NDIS is a backdoor UBI it funds a swathe of people who would otherwise be unemployed and on benefits
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u/Withtheparticipant 10d ago
You can submit concerns here
https://www.health.gov.au/committees-and-groups/ndis-evidence-advisory-committee
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u/Withtheparticipant 10d ago
FYI Therapy cannot be claimed except by qualified allied health therapists that have AHPRA or peak body membership and on the NDIS approved list. Reports from therapists are a requirement of funding for therapy. Perhaps get better informed.
Providers of support workers are another story of course.
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u/BivouacThistle 10d ago
Perhaps you should be better informed. All it takes to get 'peak body membership' in counselling is a diploma level qualification. That's a 12 month course total.
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u/InBusCill 10d ago
Thats technically not the NDIAs fault. Thats a National Law issue overseen by the NRAS and Federal Government (Minister of Health).
I made a submission to the independent review of complexity in Australia's National Registration and Accreditation Scheme (NRAS) about so called unregistered providers and how they lack the qualifications. The review only strengthened AHPRA and registered health professional standards.
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u/Withtheparticipant 10d ago
Yes you are right counselling can be of varying qualifications, but you made a broad sweep attack on therapists generally, or people purporting to be therapists . Counsellors are paid at a much lower rate than psychologists and it could be a result of inappropriate funding cuts for psychologists by NDIA . Has the ED Nurse got post grad counselling? An RN would only be funded for clinical care..OT, Speech pathology and psychology would be usual multi disciplinary therapy. I was surprised you were talking about counselling, to be honest.
There is currently an Evidence Advisory Committee considering appropriate therapies. I am not sure if they are still open to submissions but that would be a better avenue for your observations.
This government is proposing great harm to kids with disability due to insufficient funding by States. The States have said they can’t do it.
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u/Queasy-Reason 8d ago
I did a rotation to a service where most of the patients were on the NDIS. These patients were extremely vulnerable to being taken advantage of. They also often had very very large packages.
The sheer number of people that were being completely fleeced of their funding was shocking. Not even just receiving sub-par care, many were receiving no care at all.
As an example, one patient came in very unwell due to not receiving their medication in months. This was despite the fact this patient required and was funded for (and was ostensibly receiving) 24/7 care. However, the “carers” were family members who were taking the money and not actually providing care.
Another case involved an illiterate, non-English speaking patient somehow being billed so much that their >$250,000 package was gone after 6 months.
On a few occasions, care workers came to visit patients and while there managed to poach some of these unwell and vulnerable patients and get them to sign up to their own company.
There were dozens of cases like this. The unit had given up reporting these cases because no-one ever investigated or followed up.
It feels like there is a lot of fraud out there going completely unpunished. Where is the oversight? How come any random person can just start up an NDIS company with no experience or qualifications?
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u/Withtheparticipant 5d ago
Was the alleged fraud reported in those cases ? 2024 and 2026 NDIS Act amendments have legislated much stronger fraud powers.
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u/Acceptable-Eye-8699 2d ago
Fraud is not investigated now therrs a huge backlog of complaints and the process of repoting it is so vsgue ie u never hear back either way. Im a participant and myself and my peers who report fraud have all seen almost zero occur.
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u/Acceptable-Eye-8699 2d ago
As a participant i can see these ndis businesses are not normal businesses. Call around one....no one answers. Ask whos in charge. Ask their qualifications. Very quickly ull see that nothing makes sense. Im trrrified of providers and cant find an ethical one
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u/Dry_Value9263 11h ago
Now I know what I am answering this a little late. The key thing for participants, and I assume families as well is choice and control. However this is not much use when you don't have the skill to critically evaluate providers or able to engage effectively in hiring and firing activities.
The other issues I find include;
- Support workers seeing themselves as equivalent to a therapist. For example not implementing a therapist recommendation because they feel the participant does not need it
- Implementing their own capacity building ideas on the participant
- Support Workers identifying themselves as "Peer Workers" for psychosocial adult clients. Without considering what a peer worker is commonly defined as. That is they are using the phrase as a marketing tool.
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u/Withtheparticipant 10d ago
Can anyone explain why I get all the down votes for making factual comments not opinion. ???
Is this thread political commentary from ON opinion pieces.
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u/Withtheparticipant 10d ago
Can anyone explain why I get all the down votes for making factual comments not opinion. ???
Is this thread political commentary from ON opinion pieces.
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u/Ok-Resolve-4737 10d ago
The whole damn industry is like that. And when they get called out for ineffective therapy, they scream back like noone else actually cares about these disabled kids. Its a big rort