People with disabilities are waiting so long for life-changing equipment that it has become obsolete by the time it arrives.
There have even been cases where clients have died waiting for assistive technology (AT), as service providers struggle to navigate the "complex" and "bureaucratic" National Disability Insurance Scheme.
The NDIS supports disabled Australians aged under 65 by providing funds for crucial equipment, which can cost more than $50,000 – the same as a mid-range car.
When equipment is no longer effective by the time it arrives, the NDIS pays for its replacement, creating a huge cost burden for the taxpayer.
While many clients praise the NDIS' flexibility, there are growing concerns about the massive delays in the delivery of AT, which impacts their quality of life.
Old by the time it arrives
Libby Callaway, occupational therapist and board member of advocacy organisation Australian Rehabilitation and Assistive Technology Association (ARATA), said delays could cause equipment to be outdated by the time it arrived.
"One of the reasons that people are getting the incorrect AT is because of the slow processes of assistive technology approval by government funding bodies," Ms Callaway explained.
"The other issue is that people's needs can change; some people live with progressive conditions where their needs change rapidly," she said.
"Children particularly grow quickly; you can make a decision on assistive technology and then be waiting for that approval and [they] grow 10 centimetres."
Lauren Hart, manager of occupational therapy business Optimal Living said her clients often wait 12 months to receive their essential AT.
"We're urgently writing an application and submitting and chasing it up because someone desperately needs a piece of AT for quality of life... and we've got literally no control to influence the speed of the outcome," she explained.
Taxpayers picking up the tab
AT is expensive and significant delays can mean the equipment ends up costing double or triple.
This has happened to me when ordering a head pillow to go in my shower bed, with the first one I ordered ending up in France by accident.
The second arrived, but it wasn't the right product and the third was the right size and shape, but it wasn't waterproof.
After three separate purchases and more than two years of waiting, I still haven't received the right item and the NDIS have spent more than $800.
That's just the cost of off-the-shelf products, which has nothing on the price of a new wheelchair, with simple power chairs costing about $25,000.
My customised power wheelchair is $47,000 for the base and with the modifications that make it suitable for me, it will easily be over $56,000.
If the equipment is no longer effective by the time it arrives, the NDIS replaces it, meaning the taxpayer ends up paying twice.
I've been waiting to get my new wheelchair for two years and my current chair is eight years old, three years over the recommended replacement age.
The chair no longer has all its functions like reclining the back for comfort.
It's been a painful two years and I am concerned every day that ongoing wear and tear will cause another fault, such as the engine seizing while I am crossing a road.
'A waste of time and money'
Ms Hart said the process of writing AT applications was so protracted under the NDIS, that therapists didn't have time to manage their clients' needs.
"It's such an administrative, bureaucratic system that we as therapists don't get to spend the time we would like to spend, or to spend people's funding on doing therapy," she said.
"We have to spend so much time filling out applications and writing long reports that address funding criteria and chase up applications that haven't had a response for nine months and it goes on, and on."
She said long applications were the result of the NDIS system, which began a nationwide roll out in 2013.
Before the NDIS, it was easier to get essential AT but there were less options available because of price limits.
"Quite often we jump through all the hoops we're supposed to jump through and then we get a response that's clear that they haven't read what we've written or haven't read a substantial portion of it," Ms Hart said.
"It's really frustrating because you put so much energy and effort into doing what you're supposed to do; [it's] a waste of our time and participant's money."
The NDIS is managed by the National Disability Insurance Agency (NDIA), with a spokesperson assuring all replacement costs were covered by the agency.
These improvements mean that medium-cost equipment of $15,000 or less will now be approved automatically and the client can access their AT quickly. This might make it easier to purchase my next shower pillow, but it won't help my wheelchair come sooner because it's three times as expensive as the price limit.
The NDIA spokesperson said if a client was experiencing delays then they could try hiring the equipment instead of purchasing.
"In some circumstances, timely access to the right AT may be more appropriately accessed through the hiring of equipment."
Hiring is an alternative to purchasing AT and can be cheaper and quicker to arrive.
A basic power wheelchair is $4,000 to hire instead of $25,000 upfront.
The shortfalls of equipment hire
But specialised items aren't hireable, and suppliers can't always afford to lease instead of selling an item.
A lot of equipment can't be hired, even in the short term, because it is designed for specific needs.
Some AT suppliers think the NDIS is supporting equipment hire over outright purchasing.
Cary Nathan, manager of assistive technology supplier AC Mobility in Perth, said this could cause problems in the hiring industry.
"The impression I've got is that [the NDIS is] moving more towards wanting to hire equipment where they can, especially say for paediatric equipment where it may only be used for a relatively short space of time," Mr Nathan said.
"If they're going to be pushing hiring, the rates...have got to be higher for suppliers like us to invest a lot of money," he said.
But the NDIA spokesperson disagreed with Mr Nathan, saying the agency did not prefer hire over purchase and the priority was always to ensure participants got the disability-related supports they needed.
Rural areas a wasteland for disability services
Julia Salmon, an occupational therapist at Optimal Living's regional office in Albany, said suppliers needed enough clients in an area to make rural deliveries worthwhile.
"A lot of Perth suppliers will come down here now, but they need four or five clients lined up," she said.
NDIS won't pay for deliveries unless the equipment is purchased, which makes it difficult for suppliers to rent in regional areas.
Hiring equipment isn't a solution for me, both because I have specialised needs and I live in a rural part of Western Australia.
Shortage of therapists compounds the problem
About 18 per cent of Australians have a disability and with around 13 per cent of them being under 65, the NDIS has a lot of clients to support.
The scheme's flexibility has caused a boom in demand for goods and services without an increase in the number of qualified professionals who can meet that need.
There is a shortage of qualified disability workers in metro areas like Perth and that issue is compounded 10-fold in regional areas like Albany.
This is due in part to the length of time it takes to complete an Allied Health degree at university and when future OTs do graduate, they are limited by which companies will train them.
Ms Hart said the NDIS changed the financial situation for providers and made it difficult to offer on-the-job training for new graduates.
"We've had a massive boom in demand for services, but we haven't had a big enough boom in allied health graduates to keep up with, and meet that demand," she said.
"The other problem in that scenario is the lack of companies providing the training and support new graduates need to operate in this complex environment."
With low numbers of qualified professionals and long applications for every purchase, it is not surprising occupational therapists are struggling to keep up with the workload for each client.
A Department of Social Services (DSS) spokesperson said the government had invested $250 million to grow the disability workforce.
