You may have seen recent media coverage following comments from Health and Disability Minister Mark Butler about upcoming NDIS reforms and the expected “redistribution” of the allied health workforce away from the NDIS and into other sectors.

We want to be clear with members about our position, what we’re concerned about, and what we’re calling for.

Occupational therapists are essential to the NDIS

Occupational therapists are central to how the NDIS works. We are uniquely trained to assess how disability impacts participation in everyday life and to deliver capacity building supports that enable participants to develop skills, increase independence, and engage meaningfully in their homes, communities, education, and work. Through evidence based assessment and approaches, OTs identify the supports people need to achieve their goals and live meaningful lives.

Our members:

• undertake functional capacity assessments
• implement capacity building supports
• recommend assistive technology and environmental modifications
• support participants to build skills, confidence and independence over time

Without occupational therapists, the NDIS cannot function as intended. When there aren’t enough OTs in the system, participants feel it first.

Shifting OTs around doesn’t fix the real problem

We recognise that aged care, hospitals, mental health and veterans’ services are all experiencing workforce pressure. But expecting occupational therapists to simply move from one part of the system to another does not solve the underlying issue: Australia does not have enough occupational therapists to meet demand across the system.

Strengthening one system should not come at the expense of another.

NDIS reforms and assessment risks

These workforce pressures are emerging alongside significant changes to NDIS planning and assessment.

We are deeply concerned about the risks posed by the proposed New Framework Planning Rules, particularly if support needs assessments are carried out by assessors without allied health qualifications.

Occupational therapists are uniquely qualified to undertake this work. We are university trained health professionals with expertise in evidence based, person centred assessment and intervention, informed by profession specific standards and frameworks. Our practice is underpinned by advanced clinical reasoning, enabling us to translate assessment findings into recommendations and capacity building supports that respond to the individual goals, needs, and contexts of people with disability. Poorly executed assessments risk:

• inaccurate or incomplete identification of support needs
• reduced access to therapy supports
• poorer outcomes for participants
• increased plan reviews, appeals and long term Scheme costs

Occupational therapists must be a core part of the workforce conducting assessments to ensure decisions are based on evidence-informed clinical reasoning and accurately reflect participant needs, helping the scheme target supports more effectively and reduce avoidable costs over time.

Workforce sustainability starts with training — and paid placements

A sustainable NDIS workforce depends on a strong training pipeline, not just market signals.

Occupational therapy students are required to complete at least 1,000 hours of unpaid clinical placement as part of their qualification. Despite this, OT students are excluded from the Commonwealth Prac Payment, which currently supports nursing, teaching, midwifery and social work students.

This is contributing to placement poverty.

Many students — particularly those from low income backgrounds or regional areas — simply cannot afford to complete their training. Some delay their studies. Others abandon them altogether. This is happening at the same time as critical shortages in the NDIS, mental health, and rural and remote services.

We are calling on government to:

• fund occupational therapy practice placements across health, disability and community settings, and
• extend the Commonwealth Prac Payment to occupational therapy students, alongside other allied health disciplines

If we don’t invest in students now, workforce shortages will continue — no matter how demand is shifted.

What we’re doing

Our National Advocacy continues to call for:

• meaningful involvement of occupational therapists in NDIS assessment and planning
• no cuts or reductions to therapy supports
• a slower, safer rollout of NDIS planning reforms with genuine co design
• funded practice placements and inclusion of OT students in the Commonwealth Prac Payment

We will continue to advocate strongly for members and for the participants you support every day.