In the current climate of funding scrutiny and system reforms within the National Disability Insurance Scheme (NDIS), there is growing attention on cost-efficiency, particularly around allied health travel. At a glance, travel costs for therapists might appear to be a wasteful or non-essential expense. But this perspective overlooks the reality for many of the most vulnerable and marginalised people within the NDIS, those for whom community-based, face-to-face support is not a luxury but a lifeline.
The Limits of Telehealth and In-Clinic Services
Telehealth and in-clinic services do have a place. For some participants, particularly those with fewer support needs or who are comfortable with structure and technology, these options can work well. Telehealth offers convenience, can be delivered from anywhere, and allows continuity of care when travel is difficult. In-clinic appointments provide a controlled, familiar setting for some, and can bring together multiple services in one location.
But these models are not a solution for everyone, and certainly not for many people with intellectual disabilities, autism, ADHD, psychosocial disabilities, or behaviours of concern. Individuals with sensory sensitivities, difficulty managing change, or complex communication needs may find virtual or clinical environments not just unhelpful, but actively distressing.
Community-Based Face-to-Face Support Is Irreplaceable
Seeing people in their own environments, homes, schools, or community spaces, enables practitioners to understand and respond to the context in which support is needed. For allied health disciplines such as psychology and behaviour support this context is not incidental, it is critical.
Effective interventions often depend on observing natural routines, understanding triggers, and identifying opportunities for practical change. A psychologist working with a person experiencing anxiety needs to see their home dynamics or social interactions. A behaviour support practitioner needs to model strategies in real time, in real settings, where carers and family can also be coached and supported. These things simply cannot be done through a screen or replicated in a clinic room.
This kind of tailored, grounded support leads to outcomes that matter, such as safer environments, greater independence, reduced distress, and more sustainable support arrangements.
The Risks of Devaluing Travel
When funding structures start to view travel as an optional or extravagant cost, it risks sidelining those who rely on in-person services the most. For people who are unable to engage with clinics or telehealth, removing or limiting access to travel for allied health workers is not a simple cost-saving measure, it is a denial of meaningful support.
When funding structures start to view travel as an optional or extravagant cost, it risks sidelining those who rely on in-person services the most. Even if travel funding is not entirely removed, strong financial disincentives make it increasingly unviable for providers to offer community-based support. Over time, this leads to an erosion of access, where those who cannot attend clinics or use telehealth are left without meaningful alternatives. For these individuals, the loss of travel viability is not simply a matter of efficiency, it is a barrier to receiving the support they need.
Moreover, in the absence of in-home and community visits, the effectiveness of support plans diminishes. There is a real danger that time and money will be spent on interventions that do not fit, strategies that do not stick, and outcomes that are not sustained.
The Importance of Flexibility and Person-Centred Delivery
Every participant is different. Some may do well with telehealth or clinic visits, and those options should remain available. But for others, especially those who are more vulnerable, marginalised, or dealing with complex needs, flexibility is not just preferable, it is essential.
Face-to-face community-based work enables allied health professionals to meet people where they are and to build the trust, context, and connection needed for real change. It is not an indulgence. It is best practice.
Conclusion
Cost-saving measures may play a role in system sustainability, but they must never come at the cost of access, quality, or equity. Telehealth and in-clinic appointments have a place, but they are not a substitute for face-to-face support in the community, especially for those who need it most. Preserving access to this type of care is essential to upholding the values and intent of the NDIS: Delivering tailored, effective, and genuinely person-centred support.
