Health, Aged Care and NDIS Minister Mark Butler has used a major speech to set out the government’s vision for the scheme’s future, warning that growth must be contained while services are rebalanced to reflect its original intent. The following is a detailed summary of his speech at the National Press Club.

Speaking about his early career in Adelaide in the 1990s, Butler recalled visiting child care centres, aged care homes, and “the big disability and psychiatric institutions, which were still open in those days.” He compared those experiences with the position of people with profound disability today. “The difference is beyond profound,” he said.

Butler stressed that the NDIS was the product of decades of advocacy. “The disability rights movement of the 70s and 80s. The push for deinstitutionalisation. The campaign for an insurance scheme founded on ‘choice and control,’ led by Bruce Bonyhady, Rhonda Galbally and John Della-Bosca.” He credited the Gillard and Rudd governments, and ministers Jenny Macklin and Bill Shorten, with making it happen.

“Within just 12 years, Australia’s NDIS has gone from a dream of generations of disability activists to an entrenched and beloved national institution. It’s a symbol of what our democracy can achieve when we lay down our weapons and talk to each other. Proof that democracy works.”

Adolescence of the Scheme

Butler said the NDIS had now entered its “adolescence” – a time of “risks that things will run off the rails without a judicious dose of supervision and management.”

Originally intended to support 410,000 people, the scheme now serves almost 740,000 and is projected to reach a million by 2034. “When we came to government in 2022, the scheme’s costs were growing at 22 per cent per year,” he said. By comparison, Aged Care and Medicare were projected to grow at around 5 per cent annually.

National Cabinet agreed in 2023 to reduce NDIS growth to 8 per cent by 2026. “Getting growth down from 22 per cent to 8 will certainly be a substantial achievement,” Butler said. “But 8 per cent growth is simply unsustainable in the medium to long term.”

He argued that growth should stabilise closer to 5–6 per cent annually, reflecting population growth, inflation, and the ageing of participants. “The Productivity Commission’s 2017 report suggested a growth rate of around 4 per cent would be appropriate after the scheme was fully rolled out,” he noted.

Social Licence and Public Trust

Butler warned that public support for the scheme could not be taken for granted. “Although that licence is still strong, I worry it’s coming under pressure.”

Research by Talbot Mills found that while 70 per cent of Australians agreed the NDIS played a vital role, the same number thought it had grown too large, and six in ten believed it was “broken.”

“As a Labor Minister, I am utterly determined to do whatever I need to do to secure the scheme’s future,” he said.

He highlighted ongoing work on pricing, fraud prevention and provider registration. “Australians are rightly appalled by the drumbeat of stories about shonks and fraudsters ripping off taxpayers and people with a disability. And I, for one, share their disgust.”

The government has invested $500 million in fraud prevention capacity at the NDIA. In two years, this has led to more than 600 investigations and 65 search warrants. But Butler said “more needs to be done to protect the NDIS and the people who rely on it.”

One key area is provider registration. “While there are currently more than 260,000 NDIS service providers, only 16,000 are registered. I’ll repeat that – 15 out of 16 providers are unregistered.” That, he said, “has to change.”

Children and Early Intervention

Butler devoted a large section of his speech to what he called “an unintended aspect of the scheme’s roll-out” – the enrolment of large numbers of children with developmental delay and autism.

“Just under half of NDIS participants are children under 15,” he said, with half of all new entrants under nine. “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.” In some regions, he noted, one in four boys were enrolled.

“The NDIS model just doesn’t suit their needs,” Butler argued. While parents were “desperate – absolutely desperate – to get their children diagnosed because we’ve made it the only way they can get help,” the result was overservicing. “On average – just average – a young NDIS participant with moderate needs is receiving more than 70 therapy sessions per year. There is no evidence I’m aware of that supports children being taken away from learning and other activities for that much therapy.”

Instead, Butler committed to developing a new “Thriving Kids Program” outside the NDIS. “Children with mild to moderate developmental delay or autism need a robust system of supports to help them thrive. A Program for Thriving Kids. And that’s the program I intend to deliver.”

The government has budgeted $2 billion for the Commonwealth’s share of the program, to be co-designed with states, providers and parents, and co-chaired by paediatrician Frank Oberklaid. It is intended to begin in July 2026, with NDIS access changes to follow in 2027.

Building Mainstream Supports

Butler pointed to existing models such as WA’s Inklings program, Tasmania’s Child and Family Learning Centres, and Canberra’s Child and Family Centres. He foreshadowed new Medicare items for bulk-billed three-year-old health checks, as well as access to allied health therapies like speech pathology and occupational therapy.

“We will look at creating a nationally consistent online information service, like 1800MEDICARE or the Carer Gateway, that will provide parents with free supports and guidance on where to seek help if they are worried about their child’s development,” he said.

Early childhood educators and schools would also have a greater role. “Instead of the individualised NDIS approach that sees school principals reporting dozens of different therapists turning up … more coordinated supports are needed.”

Unified Health Portfolio

Butler ended by emphasising the benefits of combining health, ageing and disability in one portfolio. “This unified portfolio approach allows us to get the most out of Australia’s terrific health and social care workforce and ensure large taxpayer investments deliver the most effective benefit to patients, consumers and participants.”

He placed the NDIS alongside the PBS and Medicare as one of Australia’s most important programs. “None of these programs can operate on a ‘set and forget’ basis. They all require constant vigilance, to ensure they’re delivering for Australians who need them – and represent value for money for taxpayers. And that approach will guide how we secure the future of our world-leading NDIS.”