Across Gippsland, the Mallee, and the Wimmera, a pattern is repeating itself: therapy waitlists stretch longer, service footprints shrink, and families in need are told to hang on just a little longer. Whether it’s a toddler in Sale awaiting speech therapy or an older farmer outside Horsham recovering from a stroke, the story is familiar and quietly devastating—they’re waiting, and no one is available.
This isn’t because demand has dropped. It’s not about disinterest. It’s about design. Our systems—and specifically, how we fund and support allied health—are making it harder, not easier, to get help where it’s needed most.
The invisible cost of training
Allied health professionals in Victoria—physiotherapists, speech pathologists, dietitians, occupational therapists—typically undertake a four-year degree, often followed by a master’s. Every one of those degrees requires long stints of unpaid placement, usually totalling around 1,000 hours.
For Victorian students, that often means heading to a regional site—think Mildura, Hamilton, or Orbost—for a clinical block of 5 to 10 weeks. These placements aren’t just unpaid. They often come with a second rent, extra fuel, lost casual income, and zero financial support. Unlike nursing and teaching students—who now receive Victorian Government placement subsidies—allied health students are left to absorb the costs.
The result? Students from lower-income or rural backgrounds are systematically disadvantaged, and regional placements feel like a personal sacrifice rather than a meaningful career pathway.
Then you graduate—and the numbers still don’t stack up
Imagine you’re a new graduate OT or physio, and you’re weighing up whether to stay in Melbourne or take a job in Swan Hill. The regional position looks rewarding. There’s variety, autonomy, a sense of purpose. But here’s what else you’re calculating:
- You’ll likely need to drive significant distances between clients—40, 60, even 80km a day.
- The NDIS, which funds many of these services, used to reimburse that travel fully.
- But as of July 2025, only 50% of travel costs and time are reimbursed—meaning thousands in lost revenue.
- Even if you bill the maximum allowable rate, you’ll see fewer clients per day due to travel.
- Meanwhile, your metro counterparts can work from one clinic, back-to-back, with little downtime or overhead.
Let’s put some figures to it.
- A Melbourne-based physio or OT might see 6–7 clients daily in a fixed clinic, with annual earnings around $258,000 after expenses.
- A regional practitioner, seeing just 4 clients daily due to travel and logistics, with half their travel costs now unreimbursed, might clear just $138,000.
Same profession. Same skills. A $120,000 gap, year after year. And that’s not counting the higher business costs and lower access to supervision that often come with regional practice.
“Why not just open a clinic?”
This suggestion gets thrown around often. And sometimes it works—Ballarat, Bendigo, Shepparton. But many Victorians live in places where that model doesn’t cut it. Think of NDIS clients in Nhill, Foster, or Beechworth.
In-home visits are often essential, especially for people:
- Trialling new mobility aids
- Living with developmental disabilities
- Needing home safety modifications
- Recovering from surgery or stroke and unable to travel
The current system actively disincentivises these services—not because the clinicians don’t want to provide them, but because they can’t afford to.
Structural issues, not staffing problems
This is not a recruitment problem. It’s an architecture problem. Allied health professionals want to work regionally. The Victorian Government has invested heavily in this through the Rural Workforce Agency Victoria (RWAV), the Victorian Training Pathways (VTP) program, and Growing Allied Health Rural Victoria (GAHRV). But these initiatives only go so far when the NDIS itself undermines viability through pricing structures that don’t reflect the realities of working outside the city.
Even RWAV’s 2024 census flagged this clearly: allied health shortages in rural and regional Victoria are worsening—particularly in the Mallee, Western District, and East Gippsland. Services are closing. Waitlists are blowing out. And the workforce pipeline is getting narrower.
What we can do—right now
The solutions aren’t revolutionary. They’re practical, achievable, and overdue:
- Restore full travel reimbursements under the NDIS for allied health delivering in-home and mobile services in regional and rural areas.
- Expand placement subsidies (like those already offered to nurses and teachers) to include allied health—especially for rural clinical blocks.
- Introduce regional loadings or differentiated pricing in the NDIS to reflect geographic challenges and workforce scarcities.
- Build stronger rural supervision networks so that early-career clinicians can develop safely and sustainably outside metropolitan hubs.
This isn’t about tipping the scales. It’s about recognising that they’ve long been tilted against those serving outside the city.
Who loses when we ignore this?
We all do. When allied health workers disappear from the Wimmera, from South Gippsland, from the Upper Murray, families fall further behind. Kids miss early intervention windows. Older adults live less independently. Schools struggle to support students with learning differences. And practitioners burn out trying to do too much with too little support.
If we don’t act, the question isn’t why regional Victoria is struggling to attract allied health professionals. It’s why any of them stayed as long as they did.
