By Clare Jones (B Occ Thy)
Recent commentary around proposed changes to the NDIS and suggestions of redistributing the allied health workforce across sectors has sparked renewed debate about how Australia should be managing its health and disability workforce.
A recent position statement from Occupational Therapy Australia highlights a reality that is already well understood within the sector: occupational therapists are not sitting idle in one part of the system waiting to be reassigned elsewhere. They are already working across the NDIS, hospitals, aged care, mental health and community services, and demand continues to exceed supply.
The issue is not where occupational therapists are positioned. The issue is that there are simply not enough of them.
Occupational therapy plays a distinct and highly specialised role within the NDIS. It is grounded in understanding how disability affects everyday participation, how people manage daily routines, engage in education or work, and maintain independence in their communities.
This work is not interchangeable. It involves functional capacity assessment, clinical reasoning, assistive technology prescription, home modification recommendations, and ongoing capacity-building support. These are complex, context-driven decisions that directly influence how people with disability are able to live their lives.
Suggestions that occupational therapists can simply be “shifted” between sectors overlook the specificity of this expertise. More importantly, they risk weakening multiple parts of the system simultaneously rather than strengthening any single area.
There is no doubt that aged care, community, hospitals and private practice services are all under significant pressure. However, redistributing occupational therapists between these sectors does not resolve the underlying problem, it only reshuffles an already limited workforce.
As Occupational Therapy Australia has noted, Australia does not currently have enough occupational therapists to meet demand across all systems. Without addressing workforce supply, any attempt at redistribution simply moves the gap rather than closing it.
Concerns have also been raised about proposed changes to NDIS assessment processes, particularly where functional assessments may be conducted by individuals without allied health qualifications.
Functional assessment is not a procedural task. It requires advanced clinical reasoning, interpretation of complex presentation, and an understanding of how physical, cognitive, psychological and environmental factors interact to impact participation.
Removing occupational therapists from this process risks under-identification of support needs, inappropriate funding decisions, increased administrative burden through appeals, and ultimately poorer outcomes for participants.
If the objective is a more sustainable and effective NDIS, assessment processes must remain clinically grounded and informed by relevant allied health expertise.
A further, often overlooked, element of the workforce discussion sits at the training level. Occupational therapy students are required to complete extensive unpaid clinical placements as part of their qualification. Despite this, they are currently excluded from the Commonwealth Prac Payment available to students in other disciplines.
This is creating increasing financial pressure on students, contributing to what is often described as “placement poverty”. For some, it delays or interrupts study. For others, it becomes a barrier to completing the degree altogether.
At a time when workforce shortages are already being experienced across the NDIS, mental health and regional services, this represents a critical pipeline issue that requires attention.
If Australia is serious about building a sustainable disability and health workforce, the solution cannot be limited to moving existing professionals between sectors. It must involve expanding training capacity, supporting students through placements, improving retention, and ensuring occupational therapists are working in roles that reflect their specialist expertise.
Occupational therapists are not a surplus resource waiting to be redistributed. They are a constrained workforce operating across systems that are already under pressure.
The question is not where occupational therapists should be moved next. It is how Australia intends to sustainably support the profession that underpins so much of its disability and rehabilitation system.
As demand for Occupational Therapists continues to grow across Australia, MediRecruit plays a key role in connecting skilled clinicians with hospitals, schools, community organisations and private practices. By working closely with both employers and practitioners, we help ensure people receive timely, high-quality care while supporting a sustainable and responsive healthcare workforce.
To find out more about how we can support your recruitment needs or career goals, contact Clare at clare@medirecruit.com or go to www.medirecruit.com