ASMOF NSW - The Doctors Union has warned that the Federal Budget will place further pressure on NSW public hospitals by restricting access to NDIS supports, while failing to fix the chronic doctor shortages that are already driving unsafe workloads, burnout and delays in care.
ASMOF NSW President Dr Nicholas Spooner said proposed NDIS cuts will drive more vulnerable people into overcrowded emergency departments unless governments properly fund community, disability, psychosocial and primary care alternatives.
"There is no doubt that the Federal Government's NDIS cuts will leave vulnerable people with little choice but to seek help in emergency departments, stretching already overstretched hospitals even further.
"The fact is, when disability and psychosocial supports are reduced without properly funded alternatives, people deteriorate earlier, crises become more likely and hospitals become the default safety net.
"That worsens outcomes for all patients across NSW, with more vulnerable people turning up in emergency departments, more bed block, delayed discharges and even greater pressure on doctors who are already stretched beyond safe working limits.
"While the Budget earmarks funding for so‑called 'Foundational Supports' outside the NDIS, the scale, timing and workforce capacity of those services fall well short of what will be required to prevent people turning to hospitals."
Dr Spooner said that while some participants were expected to be redirected to new supports outside the NDIS, delivered through mainstream and community-based services, the proposed investment in those services was nowhere near enough.
"With the withdrawal of NDIS funding and without substantial investment in community-based services, unmet needs would inevitably land with hospitals and emergency departments.
"Short-term Federal Government savings will simply result in higher costs for the NSW health system.
"If people lose access to personal care, home modifications, psychosocial supports or community services, they are more likely to deteriorate and end up in hospital.
"Once admitted, many cannot be safely discharged because the supports they once relied on no longer exist, and that's a worse outcome for every patient and their family across NSW."
Dr Spooner said that the Budget also failed to address the workforce crisis facing NSW public hospitals.
"While additional hospital funding is welcome, funding announcements alone will not resolve the chronic shortage of doctors and frontline staff needed to deliver care safely.
"The Federal Government can announce new services and new capacity, but without enough doctors and health workers to deliver that care, those commitments will not exist in practice.
"There are simply not enough doctors to safely service the NSW health system.
"Doctors are already dealing with chronic understaffing, unsafe hours, overcrowded emergency departments, ambulance ramping, delayed surgery and burnout.
He said rural and regional communities were particularly exposed because disability, mental health, primary care and community services were already limited in many areas.
"When supports are cut in regional communities, there are often very few alternative services to absorb the need.
"That means the local hospital becomes the fallback, and regional doctors will feel the impact immediately."
Dr Spooner said governments needed to ensure NDIS reforms did not shift costs onto state health systems or punish vulnerable people.
"Any NDIS savings that increase hospital demand are not savings. They are an outright cost shift onto states, hospitals, families, carers and frontline clinicians, who are the ones left to pick up the pieces.
"With the NSW State Budget approaching, the NSW Government must ensure hospitals, community health services and the medical workforce are properly funded to manage the inevitable rising demand."
ASMOF NSW is calling on governments to invest in safe staffing, competitive remuneration, and conditions that retain doctors in the public system.
It is also calling for stronger disability and psychosocial supports, improved rural and regional recruitment, and expanded pathways to grow the Aboriginal and Torres Strait Islander medical workforce.
"If governments are serious about reducing pressure on hospitals, they must invest in the services that keep people well in the community and the staff who keep hospitals running.
"Without that, patients will suffer, and our already overstretched frontline healthcare workers will be forced to pay the price."
