NDIS Reform, Reality and What We Risk Losing

The recent address by Mark Bulter, Minister for Health, Disability and Ageing, sets out a clear case for reform across the NDIS and broader care systems. The themes are familiar - cost growth, fraud and misuse, eligibility, and system integrity. Those of us that have been around the scheme since trial site days, know that it has changed significantly and markedly over that time.

There are parts of this agenda that the sector will broadly support.

Stronger oversight, clearer rules, and improved visibility of claims are necessary. The reality is that gaps in the system have allowed misuse, inconsistency, and at times, exploitation. Addressing this is essential - not just for sustainability, but for maintaining trust in a scheme that represents a significant public investment. Minister Butler spoke at length about public trust, and that 7 out of 10 Australians support the NDIS, but also believe it has ‘got too big’. Six (6) out of 10 members of the Australian community think the NDIS is ‘broken’ according to that same research.

While many in the general Australian population may think that, and the influence on media that has published stories with click bait headlines arguing that $12B has been spent on “haircuts and coffee”, should be considered. Moving from projections of continued expansion towards a more contained scheme, alongside tighter eligibility and standardised assessments, signals a recalibration of what the NDIS is and who it is for and was clear in the address.

This is where the conversation becomes more complex.

Where Reform Meets Reality

For many people with disability, reform is not experienced as a policy adjustment. It is experienced as material loss. Loss to their livelihoods, their families, their communities and their wellbeing.

There were some clear statements that Social and Community Participation funding is in the line of sight for reduction – meaning tangible reductions in plan values for this category of support. Social and community participation supports was framed alongside concerns about poor-quality service delivery - such as unsafe practices by support workers. These are serious issues, and they must be addressed. But they are not the same issue.

Social and community participation is not simply a “nice to have”. It is fundamentally about connection, identity, belonging, and the ability to live a life that is not defined solely by care needs. Reducing access to these supports is not a neutral act - it changes the shape of people’s lives.

For many, these are the supports that make everything else sustainable. These supports, when provided well and directed by people with disability are what prevent isolation, reduce reliance on higher-cost interventions, and support mental health and wellbeing. When they are removed or reduced, the impact is not always immediate, but it is cumulative.

What the Data Doesn’t Tell Us

Additionally, unscheduled reviews being requested and undertaken was highlighted – namely that 1 in 5, or 20% of plans are subject to an unscheduled review, and when this occurs, plans generally increase by 20% in value. One way to look at that is that plans should not be reviewed out of cycle. Sometimes what is more important is what’s not said. What is driving the unscheduled reviews and the associated increase, if the plans had appropriate funding at the time of review? It is easy to consider that there are ‘bad actors’ influencing these plan reviews (Plan Managers were specifically called out) but there are also people with disabilities, family members and providers doing extra to gap fill while plans are inadequately funded. As always with the NDIS – the answer is more nuanced than appears at first glance.

The Risk of Simplifying a Complex System

A system that has grown quickly, and at times unevenly, does need rigour and review. Discipline applied without distinction risks collapsing different types of support into a single frame - where value is measured primarily through cost, risk, and compliance.

A central feature of the proposed reforms is a tightening of eligibility, with a clearer focus of the scheme as being for people with significant and permanent disability and moving away from a diagnosis based entry (and the end of List A). This shift is likely to be felt deeply by many individuals and families who rely on the scheme. From a system perspective, clarifying eligibility is intended to bring greater consistency and sustainability. However, its impact cannot be considered in isolation. As access narrows, the experience of those who sit outside the threshold - and the availability of alternative supports - will be critical in determining whether this change strengthens the system or simply shifts pressure elsewhere. We risk returning to those that ‘have’ NDIS funding perceived as a golden ticket rather than a necessary support, if there is nothing for those that don’t meet tightened eligibility thresholds.

What Sits Outside the Scheme

There is a question of system readiness for these reforms. If access to the scheme narrows, and if social and community participation supports are reduced, where do people go? The answer, in part, is intended to be foundational and community-based supports. Investment in initiatives such as the Inclusive Communities Fund signals that intent. At present, there is a gap between the ambition of shifting people out of the scheme and the capacity of community systems to absorb that shift. Without a corresponding uplift in those systems, the risk is not just reduced access it is unmet need.

The focus on fraud and integrity is also important, but it needs to be held in proportion.

There are legitimate issues to address, including organised exploitation and poor practice. However, most participants and providers are not operating in bad faith. If reform settings are designed primarily around preventing the worst behaviour, there is a risk that they inadvertently constrain the majority who are doing the right thing. To increase oversight, providers will be enrolled in a ‘digital payment’ system that aims to improve the quality of information and evidence required to receive payment from the NDIS.

A Shift in How the Market Operates

Significant changes were flagged for provider registration and specifically for plan intermediaries. The move towards a commissioned or panel-based model for certain supports, such as Supported Independent Living (SIL), plan managers and support coordination, represents a significant departure from an open market approach. Under this model, participants would be required to select from a pre-approved panel of providers. This change has implications that go well beyond procurement.

Choice and control have been foundational principles of the NDIS. A panel-based approach introduces logic that prioritises consistency, oversight, and manageability over flexibility, choice and innovative solutions. Panels can narrow the field of available providers, limit flexibility, and reduce the ability for participants to choose services that align with their individual needs, preferences, and relationships. For smaller or community-based providers, particularly in regional areas, there is also a risk of exclusion if they are unable to meet the requirements of panel participation.

Principles Under Pressure

The Minister’s address rightly notes that the scheme is a significant human rights achievement. That framing is important. But human rights are not preserved through intention alone. Saying ‘nothing about us without us’ and introducing New Framework Planning through an ‘evidence-based assessment’ that the disability community has almost universally condemned does not engender confidence that people with disability are in the frame for this conversation at all. On that, New Framework Planning now commences on April 1st 2027 to allow more time for discussion with community members – and hopefully – to get it ironed out before it starts.

Holding the Balance

The government has said that reforming the NDIS rests on 4 pillars: reducing fraud, slowing costs, tightening eligibility requirements and focusing on high quality supports.

If this is to succeed, it must hold both truths at once: that the system must be sustainable, and that people must continue to live full and connected lives.

The challenge is not choosing one over the other. It is designing a system that can do both. This next phase of reform will place increasing pressure on Boards, executives, and leaders across the sector. Clarity of purpose, strength of governance, and the ability to navigate trade-offs will become even more important for organisations who wish to continue to provide high quality services. Organisations will need to hold the intent of reform, while continuing to advocate for outcomes that reflect the lived reality of the people they support every day.

Getting that balance right will not be straightforward, but it will be critical to the future of the scheme.