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The importance of addressing the significant underspend on the NDIS scheme, and why the Stronger Rural Health Strategy is a disappointment for the industry

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Ed Johnson, Co-Founder and Clinical Innovation Officer, Umbo

Commentary on the $3.9bn for the NDIS

The government is yet to outline a strategy to address the $4.6bn underspend on the NDIS in 2019. One of the key reasons for this underspend is low access to supports including allied health services in rural and remote Australia. The government needs to take a more proactive approach to supporting and training allied health professionals in the regions, to enable more people to access health care through the NDIS scheme to improve their quality of life and contribute to their communities.

The NDIS Rural and Remote Strategy was due to be renewed this year, but we’re yet to see a plan that will proactively reverse the trend of underspending on the NDIS scheme. This brings little hope that the billions of dollars announced in yesterday’s budget will actually be put to much-needed use across Australia and deliver the benefits it was built to provide.

Commentary on the $550 million Stronger Rural Health Strategy

The Stronger Rural Health Strategy investment is a big disappointment. As usual, the government’s investment will go mostly towards doctors and nurses, without acknowledging the important part that allied health plays in both preventing illness and keeping people out of hospital. It’s a short-sighted plan. We have an ageing population, and populations in regional Australia are older than populations in the cities, and we have a larger proportion of community members from First Nations backgrounds.

The strategy overlooks the reality that, despite a significant and growing demand, regional communities have been and will continue to struggle to access allied health services due to a lack of adequate support from the commonwealth. While the Workforce Incentive Program means GPs can employ allied health professionals in their practices, in reality, not all patients will go to their GP for allied health services and the strategy does not include a robust enough plan and incentive to get allied health professionals into the bush. In addition, the policy omits any mention of professional support and career progression for such allied health professionals. With the current system, there will continue to be few to no allied health professionals in regional areas for GPs to refer to.

This oversight of what reforms are required to drive constructive and valuable change for rural health in Australia further highlights the ongoing passing of responsibility between the federal and state governments, with both continually washing their hands of appropriately supporting and funding the allied health industry.

The role of the National Rural Health Commissioner has been expanded to include a more holistic approach to health service delivery in the bush, which is a crucial opportunity to implement the recommendations of the previous Commissioner regarding allied health. We would greatly welcome a dedicated representative in the form of a Deputy Commissioner to look at how we can implement more integrated and holistic healthcare in the bush, connecting primary care and allied health. This is long overdue.

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Ed is a speech pathologist and PhD candidate, and has practiced across rural and remote communities for the last eight years. He is also a Services for Australian Rural and Remote Allied Health (SARRAH) board member, and sits on the Clinical Council at the Western NSW Primary Health Network. Ed’s PhD research is leading the mounting evidence for online therapy in rural and remote settings.

Ed was recognised by the Australian Allied Health Awards as the Speech Pathologist of the Year in 2018.

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