National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 – Opening statement

Dr Niroshini Kennedy and Dr Caitlin Anderson appeared at a public hearing to outline the RACP’s concerns about the proposed changes to the the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 yesterday. They shared our concerns regarding the definition of functional capacity and permanence, the reliance on mainstream supports, the impact of the proposed reassessment framework on people with fluctuating and complex needs, and concerns about the proposed static assessment process. 

Please find details from their opening statement below.

Dr Niroshini Kennedy

The Royal Australasian College of Physicians welcomes the opportunity to appear before the Committee to provide expert advice on the NDIS Amendment Bill. The RACP represents more than 34,000 physicians and trainees across 33 medical specialties in Australia and Aotearoa New Zealand. Our members work across hospitals, community settings, disability services, and primary care, including many who support people with disability every day.

My name is Dr Niroshini Kennedy. I am a General Paediatrician specialising in Developmental and Behavioural Paediatrics and President of the Paediatrics and Child Health Division at the RACP. I am joined by Dr Caitlin Anderson, a Rehabilitation Medicine Physician and President-elect of the Australasian Faculty of Rehabilitation Medicine at the RACP.

The RACP supports the intent of the Bill to ensure the sustainability of the NDIS. However, reforms must preserve timely access to supports for children and adults with disability and developmental conditions.

As a developmental paediatrician, I have seen how the NDIS can transform the lives of children with complex needs. I have also seen the harm caused by delays in assessment, barriers to access, and interruptions to support during critical development periods.  These can have lasting impacts on development, health, education, and independence.

The RACP’s first concern is the lack of a clear legislative definition of “reasonable and necessary” supports. While the Bill strengthens the link between funded supports and an eligible impairment, significant discretion remains. Decisions about early intervention, therapy and developmental supports can vary widely, creating delays and uncertainty for families already navigating complex needs.

The RACP’s second concern is the emphasis on functional impairment as the primary gateway to the Scheme. Children are not small adults - their development profiles are dynamic and evolving. Many do not present with a single definitive diagnosis, and functional impacts can change over time. Without child-specific guidance and robust assessment processes, there is a real risk that needs will be overlooked or inconsistently assessed.

The RACP’s third concern relates to the assumption that parents can provide “substantial care and support”, and that gaps can be absorbed by mainstream systems. In my experience, many families are already providing care well beyond reasonable expectations. At the same time, health, education and community services face significant capacity pressures. It is critical to consider whether these systems are adequately resourced to meet additional demand.

Finally, the RACP has concerns about reassessment arrangements. Children should not have to wait until deterioration is severe or permanent before supports are adjusted. Children’s development is dynamic, and early intervention must be timely. Reassessment must be flexible to respond to change before problems become entrenched. 

Dr Caitlin Anderson

As a Rehabilitation Medicine Physician, I provide comprehensive inpatient, outpatient and home-based rehabilitation to support people recovering from surgery, stroke, amputation, neurological conditions and complex medical events.

The key issue before us is ensuring that disability is understood as more than a diagnosis. In rehabilitation medicine, we see every day that functional capacity is shaped by more than a person’s condition - yet the Scheme largely places the burden of demonstrating functional need on the individual.

This makes the definition of functional capacity in the Bill critical. Functional capacity is influenced not only by impairment, but by access to equipment, home modifications, rehabilitation services, assistive technology, support workers and allied health care – supports that enable safe and independent participation in daily life. We support a definition that explicitly recognises these factors.

The RACP has concerns by the continued use of the term “significant impairment” without definition. This is inherently subjective, and without clear criteria, risks inconsistent and arbitrary application. People deserve transparency and consistency in how decisions are made.

While stronger mainstream supports are important, they cannot absorb the disability related needs of people excluded from the NDIS. These services should complement, not replace, dedicated disability supports where functional impacts persist.

The Bill’s approach to permanence is also concerning to the RACP. Many conditions fluctuate, with gradual improvement or setbacks over time. There is rarely a clear point at which “all reasonable treatment” is complete. Applied rigidly, this concept risks delaying access, prolonging hospital stays and requiring physicians to predict long-term outcomes prematurely. Permanence must reflect real-word circumstances, not hypothetical inaccessible treatment options.

The move toward standardised assessment tools and plan standardisation, or ‘roboplanning’, poses further risks. While consistency is important, disability is complex and cannot be reduced to a score or automated output. Capacity building supports and allied health interventions must remain individualised. Overreliance on automation risks undermining the Scheme’s person-centred intent. What is needed instead is a skilled planning workforce capable of engaging meaningfully with participants and making evidence-informed funding decisions. Without this, inequities will persist, with those best able to self-advocate continuing to fare best.

Finally, as Dr Kennedy noted, the RACP has concerns about the reassessment framework. Adults with disability experience substantial variation in their needs over time, and functional capacity may not remain stable. Regular, evidence-informed reviews are needed to ensure supports remain appropriate and responsive.