The success of child reform will depend not only on new funding or program design but also on whether governments strengthen the workforce already supporting children and families.
That question sits at the heart of growing concerns about the New South Wales Government’s Thriving Kids initiative.
Occupational Therapy Australia and the New South Wales Allied Health Providers Group support the reform’s goal of improving outcomes for children and families. However, they warn that any new service model must build on the existing allied health workforce rather than creating barriers that disrupt care or reduce access to experienced providers.
For families, the priority is simple: children should be able to access timely, high-quality support from professionals they know and trust.
Reform should build on existing expertise
Occupational therapists and other allied health professionals already play a vital role in supporting children with developmental, physical and behavioural needs.
Their work spans communication, movement, learning, emotional regulation, and participation in everyday activities. Services often include assessment, therapy, family coaching, assistive technology, and strategies that help children build confidence and independence.
Importantly, these professionals rarely work alone. They collaborate with speech pathologists, physiotherapists, psychologists, educators, and other specialists to provide coordinated care.
Many community-based providers have spent years building trusted relationships with families, schools, and local health services. Reform that overlooks this existing expertise risks duplicating services while weakening networks that are already delivering positive outcomes.
Continuity of care improves outcomes
For many families, continuity of care is just as important as access to services.
Children may spend months or even years working with the same therapist, developing trust and following personalised plans that reflect their strengths, challenges, and goals.
Changing providers can interrupt progress, require new assessments, and force families to rebuild relationships from the beginning. This can be particularly difficult for children who rely on familiar routines or who experience anxiety during periods of change.
Continuity also strengthens collaboration between therapists, educators, carers and parents, creating more consistent support across different settings.
Reform should expand access without unnecessarily disrupting these established relationships.
Regional communities cannot afford to lose providers
The risks become even greater outside metropolitan areas.
Regional and rural communities already experience workforce shortages across many allied health professions, with families often facing long waiting lists, limited provider choice, and significant travel distances.
Where experienced providers are already embedded in local communities, commissioning arrangements should encourage their continued participation.
A system that unintentionally excludes existing providers could reduce local service capacity and make some practices financially unsustainable. Rebuilding an experienced workforce in regional communities can take years.
Flexible commissioning models that allow government, not-for-profits and private community providers to contribute are essential to maintaining access across different regions.
Allied health must help shape reform
Frontline professionals understand how child and family services operate in practice.
They see where referral pathways break down, where administrative processes create unnecessary delays, and where families struggle to navigate complex systems.
Occupational Therapy Australia and the New South Wales Allied Health Providers Group have called for a formal allied health reference group to help guide the implementation of Thriving Kids.
Such a group could provide practical advice on workforce planning, commissioning models, quality standards, multidisciplinary care, and equitable access across metropolitan, regional, and rural communities.
Meaningful consultation should occur while the service model is still being developed, rather than after key decisions have already been made.
Family choice is central to quality care
Choice is more than a consumer preference.
For many families, selecting the right provider is based on clinical expertise, cultural understanding, location, communication style, or experience supporting specific developmental needs or disabilities.
Limiting provider choice may unintentionally reduce access for children with more complex circumstances.
Strong safeguards remain important. Providers should meet consistent professional standards, demonstrate appropriate qualifications, and operate within clear accountability frameworks.
Within those safeguards, families should retain reasonable flexibility to choose the professionals best suited to support their child.
Sustainable reform requires sustainable workforce planning
Expanding child and family services requires more than recruiting additional workers.
Long-term success depends on retaining experienced professionals, supporting career development, and creating conditions that encourage collaboration across disciplines.
Workforce planning must also consider supervision, professional development, administrative demands, and the financial realities of delivering services in regional and rural communities.
Commissioning arrangements influence each of these factors.
Short-term contracts, restrictive funding arrangements, and heavy reporting requirements can make it difficult for providers to retain staff or invest in service improvement.
Designing workforce strategy and commissioning together will be essential if reform is to deliver sustainable outcomes.
Reform should strengthen what already works
Large-scale reform presents an opportunity to improve coordination, access, and accountability across child and family services.
However, meaningful reform should build on the strengths already present within the system rather than replacing them.
Recognising occupational therapists and the broader allied health workforce as essential delivery partners will help preserve the expertise, relationships, and community connections that families rely on every day.
Ultimately, the success of Thriving Kids will not be measured by new organisational structures or funding models. It will be measured by whether children and families can access timely, coordinated, and high-quality support from the professionals best equipped to meet their needs.
Ritchelle is Content Team Manager at Akolade, producing stories for Australia's not-for-profit sector at Third Sector.
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