Physiotherapist Cara van Wyk is concerned about what the NDIS freeze will mean for her clients. Photo: Keeli Dyson.
Small, specialised physiotherapist services in the Illawarra on the brink of closure have been devastated by the decision to freeze their NDIS prices for the next year, forcing some to work at a financial loss or risk clients being unable to access vital therapies.
Physiotherapists who provide services through the NDIS will continue to receive a lower pay rate per client than many other allied health professionals working within the scheme, after their price limits were frozen for next year.
Cara van Wyk and the team at Neurocentric run an extremely specific paediatric physiotherapy service for children with complex neurological, developmental or genetic diagnoses.
Cara is among those frustrated and feeling the pinch, with the current $183.99 per hour price cap for NDIS clients not enough to cover costs, despite some in the community believing the funds are just padding physios’ pockets.
“The reality of that number [$183.99] is that it needs to cover rent at both our premises, it needs to cover our insurances which are very high, it needs to cover electricity, it needs to cover keeping the water on, it needs to cover award wages so that we’re paying staff appropriately, it needs to cover all the equipment that we have, it needs to cover the servicing of that equipment and it needs to cover PD to ensure that we’re offering evidence-based therapy at the best capacity – and realistically it isn’t covering that anymore,” Cara said.
While Cara and her team have cut back on travel since payments changed last year, the business is still stuck between being able to offer the service to the quality level and professionalism that is needed for clients or telling them that the doors are closing – and others are experiencing the same.
“There’s a couple of small paediatric practices in the Illawarra; we’re really lucky that there is that choice for our clients at the moment.
“We tend to be quite far apart, so families tend to go to the service that’s a little bit closer to them but there’s still choice and control around it.
“But if small businesses close down there are no other options.
Children missing out on crucial early intervention could not only have serious impacts on quality of life and progress, but will also likely cost the government more in the long run, Cara said.
“We know in the first two years of life is when neuroplasticity’s at its highest, so we try really hard to access kids at those ages and support them to develop movement,” Cara said.
“If we can teach a child to walk or to use a seated support or to stand in those really early years we’re reducing future costs.
“From a quality of life perspective that’s massive, but from a cost perspective to the NDIS that is huge – that means reduced costs of support workers, reduced costs for home modifications, reduced costs for equipment that the child might otherwise need.”
The NDIS doesn’t allow providers to charge beyond the capped price, but even if paying a gap was a possibility for the business, Cara said it would be terrible for families, with the private cost to see someone with her level of expertise equivalent to around $250.
“We would hate to say to a family you can’t access this service because you can’t pay more out of pocket,” Cara said.
“If I had to say to every client, you need weekly sessions but you have to pay $70 out of pocket for that, that’s not feasible. Ethically I can’t do that. People would have to go into debt to access these services and that’s not appropriate either.”
Whitlam MP Carol Berry said the annual pricing review conducted independently by the NDIA each year “is the most informed review to date, drawing on extensive consultation with participants, providers and the sector”.
“It is based on analysis of more than 16 million transactions from a range of sources including private health insurers and comparable government schemes such as Medicare.
“It recommended some targeted adjustments are needed to keep NDIS pricing fair and in line with other markets like veterans affairs and aged care.
“This is to make sure that prices which are paid by NDIS participants to providers are fair and sustainable.”
But the Australian Physiotherapy Association (APA) commissioned an independent report following last year’s cuts that revealed the NDIA’s pricing approach relied on limited data and included flawed assumptions such as incorrectly estimated session times distorting true costs, and the modelling failing to reflect the complexity involved in providing high-quality services to people with disability.
“Furthermore, our understanding is that the scheme currently lacks a comprehensive, transparent mechanism to track provider entry and exit, or changes in service capacity,” APA president Dr Rik Dawson said.
“In this context, the absence of evidence cannot be considered evidence of a well-functioning market.
“The annual pricing review does not address these concerns, despite the NDIA identifying similar uncertainties in its own analysis, and instead defers substantive analysis to future work, yet still locks in current prices.
“Instead of considering the Nous Group’s findings or ensuring sufficient evidence before making such a consequential decision, the NDIA has instead placed more pressures on the high-quality, highly regulated and evidence-based health professionals who have long been the backbone of the NDIS.”
Ms Berry said that she was “always concerned about the possibility of losing quality providers from the NDIS market “and would be “watching developments closely.”
Original Article published by Keeli Dyson on Region Illawarra.
