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and families were assisted to support optimal communication,
eating and drinking for all residents.
After a period of time, advances in outcome measurement and
the findings of extensive research investment that had been
a key feature of the new approach meant it was possible to
demonstrate a high return on investment for services to young
children, adolescents and adults with disability and chronic
and complex needs. As a result, a long-term commitment
to continue funding these approaches for these groups was
supported strongly. The focus was on supporting function and
participation, and building the capacity of the individual and
the community. Services for older people in the health sector
focused on supporting those who had a prospect of making a
good recovery.
Speech pathologists continued to work across private, public
and not-for-profit settings. However, funding models changed.
Individualised funding continued for a tightly prescribed,
targeted group of clients. Others seeking individual services
were required to cover the full cost independently or through
private insurance.
As the roles, work contexts, and visibility of speech pathologists
in the community changed, the profession started to attract a
different mix of individuals to what it had in the past, including
people with different career interests and aspirations. A
proportion of speech pathologists who could not find roles to fit
their skills and interests in the new paradigm moved on to other
areas of practice and different professions.
Although it took time, gains in outcomes across the community
in health, educational, social and employment outcomes
emerged. Most notable was the significant reduction in the gap
in outcomes across the community.
What if…
What if governments chose not to fund services
for the very elderly or terminally ill?
• What are the ethical issues involved in taking
this stance?
• How could speech pathology be proactive in
preparing for such a possibility?
What if the bulk of health and human services
funding was shifted to universal and early
intervention approaches?
• What advantages and disadvantages would
this bring to individuals and the community?
• What changes would need to be made to
training, practice, research and other systems
in the speech pathology profession?
What if speech pathology became more visible in
the community?
• What partnerships and new practices would
have facilitated this?
• Would this help the profession attract a more
diverse workforce? What other strategies
might be required to increase workforce
diversity?