Why Allied Health Advocacy in the NDIS Keeps Missing the Point

A long form perspective from inside the sector

Introduction

This year has reshaped the way Allied Health engages with government, policy and public expectations. The APR, PAPL, I-CAN, Thriving Kids and broader NDIS reform agenda have pushed many clinicians and providers into advocacy for the first time. Not because they are naturally inclined, but because the pressures on pricing, sustainability and workforce have become impossible to ignore.

Some advocacy has been strong. The APA’s recent reports: Review of the 2024-25 APR with respect to physiotherapy and the Hourly rate for the provision of physiotherapy services are fantastic contributions. They are evidence based, clearly argued and engage seriously with the complexity of the scheme. We need more advocacy of this quality. But even strong advocacy shares a recurring limitation. It focuses on hardship, cost pressures and sustainability challenges without answering the question that ultimately determines whether government will invest more in therapy.

Why should the government direct more public money into Allied Health?

This is the missing piece of the conversation. We describe the pressures the system is under, yet remain vague about the value proposition that justifies higher public investment. Advocacy has been passionate, urgent and well intentioned, but unless we can articulate the public value case clearly, advocacy will continue to hit a ceiling.

Before going further, it is important to acknowledge something directly. None of what follows is intended to diminish the enormous amount of effort clinicians, providers, peaks and community members have put into advocacy. There has been genuine commitment, thoughtful submissions and a real desire to improve the system. I am hesitant to publish a piece like this because I am acutely aware of how much people care and how hard they have worked.

My intention is not to criticise the people doing the work. It is to step back and ask that why, despite the effort, we have seen very little movement. If outcomes are not shifting, perhaps the sector needs a different framing or a different starting point. I hope this perspective adds something useful, even if some parts feel uncomfortable.

Acknowledging My Position and Bias

If I am going to comment on advocacy, I need to be clear about where I sit. I am a Physiotherapist by background, but in my previous business I spent most of my time leading a team of more than 300 clinicians across ten disciplines. The majority were OTs, speech pathologists, psychologists and PBS practitioners. That experience shaped how I view the sector. I do not approach these issues through a Physio lens. I see myself as an Allied Health all rounder who wants every discipline to be valued and supported.

I now work with providers of all sizes, from sole traders and small startups to medium services, large national organisations and NFPs. My work spans across different funding areas and schemes, mainly Aged Care alongside the NDIS. That range gives me a broad understanding of how reforms affect different business models, regions and professions.

Additionally, my workload increases during periods of reform and uncertainty. When the system becomes harder to navigate, more providers seek guidance. I believe this work is useful, but it also means I benefit when the environment is complex. That creates a bias worth naming.

There are biases everywhere in this sector. Providers want sustainability. Clinicians want manageable workloads. Participants want reliable supports. Peaks want influence. Government wants affordability and stability. Everyone, including me, has incentives and blind spots in this space. Being aware of them helps us approach advocacy more honestly.

Transparency strengthens credibility. Advocacy is taken more seriously when motivations are acknowledged honestly rather than ignored.

The Central Question We Keep Avoiding

The most important question in Allied Health policy is also the one we rarely address directly.

Why should the government invest more in Allied Health?

This sits at the core of every pricing review, reform package, budget conversation and political debate about the NDIS. We often leap straight into describing pressure and hardship, but hardship is not the argument that unlocks public funding. Treasury and Finance allocate dollars based on value, impact and cost avoidance. They want to understand how therapy, for example:

• prevents escalation and crisis

• reduces personal care hours

• reduces avoidable hospital presentations

• increases independence and functional capability

• reduces long term support needs

• improves workforce participation

• reduces demand for higher intensity supports

These are the outcomes that must be articulated clearly. Inside our bubble, we already know Allied Health helps to achieve these things. The challenge is that we have not consistently proved it, quantified it or communicated it in a way that resonates with Government decision makers.

This all sits within a larger fiscal reality. The government has made its position clear. NDIS growth must slow. In a constrained environment, higher investment in one area requires less investment elsewhere. Even if some believe the NDIS should continue expanding, the broader truth remains unchanged. No public system has unlimited funding. Every dollar spent on therapy is a dollar not spent on aged care, hospitals, education or infrastructure.

This is why the value case cannot be optional. It must be central.

Understanding Public Perception

Public sentiment shapes political appetite for investment. Many Australians do not understand the role or value of Allied Health. If you look at social media and public commentary around the NDIS, you will see frustration, scepticism and an assumption that the scheme is undisciplined, that providers are well paid, or that the system is a rort. Whether this perception reflects reality is beside the point. It exists, and it shapes political behaviour.

That perception is not always accurate, but it influences how governments respond to calls for higher prices. If the public believes the NDIS is inefficient, they will not support more money flowing into therapy. And without public support, political support will always be limited.

Advocacy cannot rely on sympathy. It must articulate public value.

The message cannot be that providers are struggling and therefore prices must rise. It must be that the right therapy investment saves money, improves outcomes and benefits the community. That is the narrative that influences budgets.

The Trap of Hardship Based Advocacy

A significant portion of sector messaging focuses on hardship. Providers are under pressure. Workforce shortages are acute. Margins are thin. Travel cuts have reduced viability. These are real issues, but hardship is not a compelling argument for public investment. It explains why providers feel stressed. It does not explain why the public or government should care.

Hardship based advocacy can backfire. It can sound self focused. It can alienate participants who also experience hardship. It can reinforce public scepticism that providers are seeking higher pay rather than better outcomes. And it can obscure the broader value argument.

Advocacy becomes more powerful when it connects provider sustainability to participant outcomes and long term system savings. A sustainable workforce creates continuity of care. Continuity of care drives functional gains. Functional gains reduce long term costs. That is the chain of logic policymakers respond to.

At the moment, too much of our advocacy asks for sympathy, not proof of our value.

Government and NDIA Are Not the Enemy

It is easy to fall into an adversarial mindset, but most people inside the NDIA want the same outcomes clinicians and providers want. They are balancing participant needs, fiscal pressures, public scrutiny and political realities. These constraints shape every policy decision.

It is also important to remember the scheme exists for participants. Providers are essential, but the system is not designed around provider sustainability. Advocacy that frames sustainability as a foundation for participant outcomes has far more influence than advocacy that frames providers as victims of reform.

The more we position government as the villain, the less credible we become. The more we understand their constraints, the more influence we gain.

The AI Slop Problem

There is another issue that has quietly weakened the sector’s advocacy. Across several recent consultations,, many submissions show clear signs of being generated by AI and left largely unedited. The same structures, generic phrasing (and excessive use of em dahses) appear repeatedly, including in some organisations that would normally lead the conversation.

This is visible in the publicly available Thriving Kids submissions, where many documents contain generic or obviously AI generated content.

Using AI is not the problem. Submitting unedited, generic content is. Policymakers read hundreds of submissions and can see instantly when material has not been crafted with care. It signals low investment in the process and weakens the credibility of our arguments. High quality advocacy requires thoughtful, refined and context aware contributions. AI can support the drafting process, but the final work must reflect human expertise and the lived reality of the sector.

If we want policy teams to listen, we need to lift the standard of our submissions. Quality matters.

What Effective Advocacy Could Look Like

If Allied Health wants to influence the next chapter of reform, advocacy must move from describing pressure to demonstrating value. The core question government keeps returning to is simple.

Why should public money go to Allied Health rather than any other competing priority?

Effective advocacy answers this with evidence, numbers and dollars.

1. Target investment where therapy delivers the strongest return

Not all therapy generates the same long term value. Advocacy is most compelling when it focuses on areas where evidence is strong and return on investment is clear.

Government can justify higher investment when it improves:

• outcomes for complex disability or high support needs

• access and sustainability in regional and remote communities

• early intervention programs with evidence of long term cost avoidance

• services delivered by providers who measure outcomes and operate efficiently

Targeted investment is far easier to justify rather than blanket increases.

2. Acknowledge system inefficiencies and provide solutions

Reforms like I-CAN and Thriving Kids were introduced because government identified inconsistent practices, cost pressures and unclear value. Whether every detail is correct is debatable, but the underlying concerns are real.

Effective advocacy:

• recognises the pressures government is trying to address

• identifies inefficiencies honestly

• proposes practical and evidence based alternatives

This positions Allied Health as a partner rather than an opponent in reform.

3. Strengthen integrity and quality

If we want higher public investment, we need a system government can trust. Advocacy should support:

• removal of unsafe or unethical providers

• better oversight and accountability

• regulation of sole traders and unregistered providers

• proportionate regulation that protects participants

• clearer expectations of quality and measurable outcomes

Higher integrity makes investment easier for government to justify.

4. Anchor advocacy in evidence, data and dollars

Influential advocacy speaks the language of government. That language is evidence, numbers and dollars. Policymakers need clarity about:

• what downstream costs therapy prevents

• what escalation it avoids

• how it changes long term support needs

• how it reduces personal care hours

• how it affects hospital use

• how functional gains translate into measurable savings

This financial logic is the core of the why. Without clear data and cost reasoning, advocacy sounds genuine but incomplete.

5. Lift the quality of submissions and remove generic content

Policy teams read hundreds of submissions. Many are repetitive, generic or clearly drafted by AI and left unedited. This weakens credibility.

Using AI is not the issue. Submitting unedited AI content is.

High impact submissions:

• reflect genuine sector expertise

• use clear evidence, data and cost logic

• propose realistic and implementable recommendations

• show an understanding of system constraints

• are written in a clear, authentic organisational voice

Thoughtful submissions show seriousness and support the value case we are trying to make.

Summary

The sector is full of people who want the same thing: a system that works, participants who receive effective supports, providers who operate sustainably without overservicing and a scheme strong enough to exist for decades.

If our advocacy is going to influence the next wave of reform, it needs to evolve. It needs to answer the WHY with clarity and evidence. It needs to speak the language of value. It needs to be grounded in outcomes, not frustration. And it needs to be more targeted and more constructive than the broad calls of the past.

If we can do that, the case for investment becomes clearer, public confidence strengthens and our collective voice becomes far more influential in shaping the future of the NDIS and Allied Health.

If we want advocacy that actually influences NDIS reform, it starts with why.