More than half of GPs support the government’s plan to move children with mild to moderate autism and developmental delay off the NDIS, in favour of a new support system which will leverage mainstream community-based services to reduce pressure on the system and curb burgeoning costs.

In fact, just 18% think the NDIS is working well for these patients, a Healthed survey of around 1200 GPs has found.

In announcing ‘Thriving Kids,’ the system set to replace the NDIS for these children, Health Minister Mark Butler made it clear that in his view, they are being over-serviced.

“I think most Australians would be alarmed to know that 1 out of every 10 6-year-olds are in the NDIS, including 16 per cent of 6-year-old boys,” he said. “Frankly, many of those children are then being over-serviced.”

“The extent of therapy provided to those children now in the NDIS is extremely high, compared to anything you’d see in the health system,” Minister Butler continued.

However, that’s where GPs and the Health Minister diverge. Just 17% of doctors in the survey feel the level of support that paediatric patients with mild to moderate autism or developmental delay currently receive from the NDIS is excessive in relation to their clinical needs.

Still, most GPs agree something needs to change.

Aside from the 54% who support a separate program for this group of kids, a further 28% said while they don’t support this solution, the NDIS isn’t working either.

Many GPs who support reform see the NDIS as wasteful, misused or financially unsustainable.

According to Minister Butler, the NDIS expenditure has outstripped expectations, with the scheme forecast to cost $105 billion and increase its GDP share by 0.5 per cent over the next 10 years.

Several GPs in the survey supported providing early intervention through a parallel or school-based system rather than the NDIS, which some said was overly medicalised and bureaucratic.

Lack of input from those most affected

While many GPs broadly support the initiative, there are also signs of concern.

Four in 10 GPs said they have at least one parent of a paediatric patient with mild to moderate autism who is worried about how their child’s care will be impacted.

“The parents are already in a lot of stress. And with this new change they fear treatment may get disrupted,” one commented.

“They have all spent months navigating the current matrix … and to start over is just exhausting,” another said.

Clinical psychologist Professor Tony Attwood, who has specialised in autism for over 50 years, is concerned that there may not be enough input from the people who will be most affected by the changes.

“I have a suspicion that it may be bureaucrats and accountants who determine this, not specialists in the area,” he said. “And including what the parents say is needed. But also, that autistic individuals themselves are consulted about their services.”

Potential gaps in care

Professor Attwood is also worried about what will happen once these kids get older.

“What the government said is autistic people are going to come off the NDIS. Okay. And they’re going to be under a new program, grandly titled Thriving Kids. Great. But you don’t stop being autistic when you grow up. What about adolescents and adults? They need support too,” he said.

“There are horrendous problems that often occur with the onset of puberty. And what are we going to do about adults who have not only confirmed mental health issues, but also employment issues and the need for that support for families?”

For now, details are vague. Minister Butler has promised to work with states, service providers and parents, as well as paediatrician and childhood development expert, Frank Oberklaid AM, to flesh out what the new system will look like. He hopes to roll out Thriving Kids from 1 July next year, with NDIS access changes taking effect in mid-2027.

What your colleagues are saying

In favour of the new program:

“Could allow better management of support services for the increasing common occurrence of developmental delay and autism.”

“Early intensive allied health input is really important for young children with autism and can improve their functioning which will make a huge difference to their lives.”

“Early intervention is the key so if there is less red tape, and earlier intervention, outcomes would be better.”

“I consider that this is a good initiative, because too much money in NDIS is being consumed by some of the unscrupulous providers and to have this new initiative as a standalone hopefully will achieve the same outcomes and save money.”

Cautiously optimistic:

“As long as this cohort still receives appropriate support depending on their needs.”

“Hopefully it will reduce government (taxpayer) expenditure.”

“I believe the intention behind Thriving Kids to provide early, community-based support and relieve pressure on the NDIS is compassionate and logical in concept. When done with evidence, empathy, and co-design, stepped-care models hold tremendous promise.”

“If – and specifically if – the new support program is well designed. Do we trust politicians to do this?”

Critical of the changes:

“Australia is running out of money for NDIS but trimming it from autistics will be counterproductive. They need extra care.”

“Another bureaucracy costing more than before in a grossly expensive NDIS system.”

“Autism children are benefiting from the current NDIS program.”

“I despair at the financial inefficiency of setting up yet another program under a different name simply to divert the funds from one program to another and in the meantime causing much distress, insecurity and fracturing continuity of care for the recipients.”