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

Dr RYAN (Kooyong) (13:19): I move amendment (11) on sheet 1, as circulated in my name: (11) Schedule 1, item 92, page 36 (after line 12), after subsection 25A(3), insert: (3A) A person is not required to undertake treatment that is: (a) unreasonably inaccessible or unavailable; or (b) not clinically appropriate; or (c) associated with unreasonable risk. Among the most concerning provisions in this bill is the new definition of 'permanent' disability for eligibility purposes.

Under the bill, an impairment will only be considered permanent—and therefore make the applicant eligible for NDIS support—if all appropriate treatment options have been exhausted; no further treatment is likely to materially improve, reverse or alleviate the impairment; and the impairment is likely to persist for a lifetime. Applicants must have tried all treatments commonly available in Australia, regardless of whether or not they can afford them or whether the treatments are accessible where they live.

Persons in rural and regional Australia might not be able to access specialist treatment that is theoretically available in a capital city. The House Standing Committee on Health, Aged Care and Disability is looking into this issue at this very time. A person with limited income may not be able to afford treatments.

Even though the government has assured me that 'appropriate treatments' means those listed on the PBS, many items on our Medicare schedule still have associated out-of-pocket costs, are not readily available at times and may be out of reach for some individuals. What the government is trying to do in legislating this definition is to overturn the Federal Court's previous decision in Davis, which established the precedent that financial circumstances must be considered when determining if treatment is available.

Whether a person can afford a treatment will form part of the factual circumstances that a decision-maker may need to examine in deciding if a treatment is one that an individual can, in reality, access. The Federal Court applied the ordinary meaning, which is a fair meaning, but the exemptions in this bill are too narrow; that's my proposition today. Proposed section 25A(3) excuses a person from treatment only for medical reasons, not because of cultural or personal belief or bodily autonomy.

The Justice and Equity Centre has told this parliament already that 'this approach unjustifiably interferes' with a person's 'right to bodily autonomy'. It's not enough to leave this to the rules to be made later by the minister. They are rules that don't even require agreement from the states and territories.

That is not going to reassure vulnerable individuals. Because permanence is part of both the disability and the early intervention access criteria, the government's bill directly affects eligibility to entry to the NDIS and continued access when a person's status is reconsidered. There is a profound and unresolved circularity here.

For many people with a disability, accessing the NDIS is precisely how they can access ongoing treatment. Without the NDIS, they may well not be able to do that. The bill proposes to deny access to support until treatment has been exhausted, without acknowledging that the capacity to access treatment may itself depend on having NDIS support.

For example, if a treatment might result in improvements over many years but the person would still have substantially reduced functional capacity, they may be prevented from accessing the NDIS in the meantime. The bill could also make it harder for people with progressive conditions to access the NDIS, even where treatment only slows but cannot reverse the deterioration of their functional capacity.

The government assures me that these examples won't eventuate, but the government is unwilling to provide that express safeguard in this legislation. The Australian Human Rights Commission has submitted that the definition of 'appropriate treatment' in the new section 25A will 'significantly restrict access to the NDIS and undermine a rights based approach to disability supports'.

Amendment (11), which I have moved today, addresses these concerns. It expressly provides that a person is not required to undertake treatment that is unreasonably inaccessible or unavailable, is not clinically appropriate or is associated with inappropriate or unreasonable risk. The government has framed this bill as a matter of sustainability for our economy.

Sustainability can't just be achieved by narrowing the gate. If we define permanence in a way that excludes people who lack the financial or geographic means to access treatment, we're not securing the NDIS; we are rationing it according to circumstance and financial status.