NDIS to cover alternative therapy

Alternative medicines and treatments such as chiropractic therapy will be paid for by the national disability insurance scheme.

Chiropractors, as a profession, have often courted controversy and some have been aligned with anti-­vaccine fringe groups.

Alternative medicines and treatments such as chiropractic therapy will be paid for by the $22 billion national disability insurance scheme because the legislation is not clear on the kinds of evidence required to prove what help is “effective”.

Documents obtained under Freedom of Information laws reveal the NDIS agency is grappling with the fallout of an Administrative Appeals Tribunal decision that declared chiropractic therapy was “reasonable and necessary” under the existing legislation.

Kylie McCutcheon won the right to have the NDIS pay for her chiropractors because without them, she said, her back pain — caused by spina bifida and scoliosis — had worsened and left her in a wheelchair.

“In all the circumstances, Ms McCutcheon’s lived experience must be given very considerable weight,” senior member Jill Toohey wrote in her decision. “I am satisfied that there is sufficient ­independent evidence before the tribunal to support the conclusion that, insofar as it maintains her mobility and functioning, chiropractic treatment will, or will likely, be effective and beneficial for Ms McCutcheon.”

The chief executive of the NDIS must consider whether a treatment for a person is “effective” and in line with “current good practice”. There is no specific mention in the NDIS legislation or accompanying rules that elaborate on what good practice might mean and the rules do not limit the types of evidence which are permissible.

One expert rehabilitation physician, who gave evidence at the tribunal, said she did not question the role of the chiropractor in maintaining the functioning of Ms McCutheon but did question “how much this was attributable to the psychological effect of (her) ‘faith’ in the treatment’’.

Chiropractors, as a profession, have often courted controversy and some have been aligned with anti-­vaccine fringe groups.

Minutes of the Independent Advisory Council’s meetings, ­obtained by The Australian, show the concern with which the ­appeals tribunal decision was treated at the time. “The council noted that a recent (AAT) decision determined that chiropractic treatment included in a participant’s plan could be classified as a reasonable and necessary support,” it says.

“The council noted the broader implications of this decision with regards to the services that should be funded by the NDIA or the mainstream health system.”

In its submission to an independent review of the NDIS legislation late last year, the agency requested changes to the scheme’s rules that would give greater clarity to the evidence it deemed ­appropriate in cases like this.

­Spinal orthopedic surgeon John Cunningham told The Australian the case had implications for what was allowable under the scheme. “There is absolutely no evidence that anybody ever needs their neck manipulated or ‘put back into place’ by a chiropractor — ever,” he said.

“Chiropractic therapy has a small advantage over normal medical care in the treatment of acute back pain, short-lived back pain; it has little role to play in chronic back pain and there is ­absolutely no evidence that it works in the treatment of long- term back pain.”