The million-dollar question: What are the ethical considerations of public funding provisions for Australian speech-language pathologists engaged in independent practice?

Health funding arrangements subsidised by the public purse provide a necessary conduit for families to access private speech-language pathology (SLP) services in Australia. In principle, public funding models (PFMs) champion the ideals of universal access. However, stakeholders ministering contemporary public funding provisions anecdotally report being incessantly afflicted with ethical challenges and dilemmas. This qualitative research describes the perceptions of speech-language pathologists (SLPs) in observing principles and values of ethical practice when accessing public funding provisions for children and young persons with communication and swallowing needs (CSN) within Australian independent SLP practices. Original data analysis revealed five predominant themes: (a) securing funding provisions, (b) time as a commodity, (c) incongruence between funding provisions and SLP evidence, (d) trust as a multifaceted quality, and (e) consequences of funding models. When re-analysed through an ethical lens, data illuminated the diversity of ethical principles and values raised by participants. As stewards safeguarding scarce public resources and committed to ethical integrity, SLPs are challenged to rigorously appraise PFMs through health-economic measures of equity, efficiency, and acceptability. [ABSTRACT FROM AUTHOR]