16/06/2025
The NDIA have made the disappointing (and I believe dangerous) decision to reduce dietitian rates by $5 per hour. Not only have they not kept up with inflation for the last 6 years but they have actually reduced our pay. While everyone else's pay goes up, ours goes down, and ultimately this will affect access to quality allied health supports for people with disabilities.
While I'm sure everyone could appreciate they would be livid if their employer told them they'd be cutting their wage, it can be easy to think that even after the reduction that's a good hourly rate - $193.99 to $188.99, who cares, right?! The reality is running a business and complying with accreditation is extremely expensive, profit margins are slim, and that reduction adds up to enough for businesses to lose viability.
I, like almost all dietitians work multiple jobs, currently I have 4 jobs but for simplicity sake let's say I work in the public sector and run my private practice.
As a telehealth business, my overheads are much lower compared to businesses with mobile businesses or clinics. For simplicity sake I'm going to run these calculations as if I am 100% NDIS based, which I'm not, and I will also include the marginal income I've earned from selling products. Using current financial year data, after expenses, my take home pay from private work is roughly 1/4 of the scheduled fee (at $50.33 ph) keeping in mind that wage is without any entitlement to paid time off, annual leave, sick leave, or super. In my public health job, as a part time employee with all the entitlements that go along, I earn roughly $52 ph (plus super). As inflation goes up profit margins go down without fee increases. I don't know how expensive my overheads next year will be, but I do know that if everything stayed exactly the same, a $5 hourly reduction would mean $45.33 ph while my public job wages will continue to increase.
So what's the logical move for me? What if I get offered another day of work and that means shuttering my private practice? I can tell you, because it's already been happening. For the last year I have picked up extra shifts in my public health job whenever possible and have closed myself off for private appointments. I have resisted closing my private practice entirely because I so strongly believe that people with disabilities should have access to the provider of their choosing (choice and control!), but at some point it is no longer viable to accept losses of this magnitude. I will be forced to either remove myself from the market, (therefore removing the opportunity for clients to receive care that I am specialised to provide) or will have to ask participants to pay me my full fee upfront and leave it to them to claim back from NDIS with a gap fee out of pocket... The latter of which is not at all realistic because disabilities often come with extremely limited financial resources.
Some have suggested that providers can make up the differences by extending appointments for a few minutes, even if this wasn't ethically questionable, it's also not a viable option, particularly for dietitians. We're lucky for participants to get even 10 hours of dietetic funding annually, funding is not unlimited.
Providers are already stretched thin, we are already making sacrifices, we are already doing unpaid work outside of consult time because our participants do not have enough funds to pay us for actual time spent. We cannot realistically be asked to do more for less.
Providers will leave private work.
Providers will leave the NDIS "bulk billing" model
Participants will lose their choice and control.
Participants will go without their services.
Health will suffer, some people will even die - all because the government decided small and independent businesses can take the hit.
People are saying it's much ado about nothing, but that's why we're all so upset.
