foundational supports

Big Picture:

Many allied health providers straddle and navigate three imperfect systems to support clients: health, education and disability. Ahead of the Federal Election, the Grattan Institute has published its helpful 2025 Orange Book, setting out what it sees as policy priorities for each of these systems, regardless of who wins. Here are some takeaways:

Context:

• To maintain systems and to improve living standards for Australia, we need productivity growth. 
• To improve productivity, the government needs to strengthen our foundations, including health and education for all Australians, including for people with disability.

Health:

• More focus on preventing chronic disease (including incentives to encourage better diets, more exercise, fewer drugs and less alcohol, and more social connection).
• Fund Primary Health Networks to create more multidisciplinary primary care teams – especially in under-served areas – with implications for scope of practice, workflows, supervision, teamwork, and business models/fees.
• More support for GPs, including a shift away from “fee-for-service” service payments and better access to specialist advice.
• More transparency on fees charged by specialists. 

Education:

• Lift our game to ensure more students leave schools with essential skills, like reading and numeracy: currently ⅓ of students – 1.3 million students – are at risk of leaving school without essential skills.
• Set more ambitious targets, e.g. that at least 90% of students reach proficiency in reading and numeracy.
• Mandate phonics checks across all schools in Year 1, with a Year 2 re-sit for at-risk students.
• Invest more in:
  • research to identify best practices in real world school settings (e.g. like the Australian Education Research Organisation’s work on secondary literacy instruction); and
  • an independent, non-government, not-for-profit body to quality assure curriculum materials (like EdReports in the USA).
• Support teachers with evidence-informed guidance, and professional development and training, starting with reading and maths instruction, linked to practical materials (e.g. off-the-shelf curriculum materials and assessment tools) so all teachers have access to high quality materials including teachers working in disadvantaged schools.

Disability: 

• Stay the course on NDIS reforms to realise the original vision of a multi-tier scheme with different levels of coverage, clear eligibility criteria, data-led resource allocation, and proper operational risk management.
• Implement a fair, objective, and consistent method for allocating NDIS support packages (including, controversially, a standardised assessment and planning framework). 
• Re-think Section 10 and interim rules about NDIS Supports, which constrain participant choice and control. 
• Empower the NDIA to become a more active steward to encourage innovation, intervene when markets fail (e.g. by commissioning services directly), and create a network of regional hubs mirroring the Primary Health Networks.
• Invest seriously in Foundational Supports (including by redirecting some NDIS funds) so that the wider population of disabled Australians have their needs met, while reducing pressure on the NDIS.
• Integrate and deliver Foundational Supports in mainstream settings.

Bottom Line: 

• The major parties – and most of us – want a healthier, more prosperous Australia that allows everyone to live a good life. But times are uncertain, resources are limited, and current systems are imperfect. 
• Because of our work, allied health providers are in a unique position to:
  • understand the interdependence of health, education and disability systems; and 
  • recognise that changed policy settings in one system can have significant, sometimes unintended, knock-on effects to other systems.
• To help support participants and other clients, governments should prioritise a new National Disability Agreement clarifying how mainstream health systems, the NDIS, Foundational Supports, mainstream childcare, education and other systems will work together to:
  • support Australians, including people with disability and developmental delay; and 
  • give at least a bit more certainty to the allied health providers who support them, so we can make investment, recruitment, service mix, and other business decisions needed to stick around.

Go deeper:  

Orange Book 2025: Policy priorities for the federal government – Grattan Institute (Errors of interpretation and emphasis in this summary are my own.)

Unleashing the Potential of our Health Workforce – Scope of Practice Review Final Report

Australian Education Research Organisation

EdReports (USA)

More from us:

Allied health NDIS providers must face facts, and make painful – but necessary – changes to survive

Allied Health NDIS Providers: Keep your eye on the ball in 2025!

Allied health NDIS providers: back yourself to try new things, and help more people: a case study

NDIS “ins and outs” for participants seeking “mixed” disability, health and education supports: mind the gaps between NDIS and mainstream services