Build the SLT workforce — so people are safe to eat and free to communicate.

SLTs help people communicate, understand others, and swallow safely.  Their work prevents hospitalisations, supports independence, helps children learn, and protects basic human rights — like being able to express pain, ask for help, or make decisions about your own life. 

Across New Zealand, access to speech-language therapy depends on where you live, which agency you’re dealing with, and whether the local workforce has enough staff. 

This leads to: 

• Years-long waitlists for assistive communication technology 
• Disabled people in residential care at risk of preventable choking and harm 
• People with dementia going without essential communication and swallowing support 
• Whānau experiencing significant stress because help is not available.

Doing nothing costs more in hospital admissions, residential placements, and crisis responses. 

NZSTA is asking Government to fund a modest increase in SLT staffing in three key areas: 

• Assistive Technology & AAC – 20 SLTs in year one, then 10 each year ongoing 
• Dementia care – 10 dementia specialist SLTs nationwide 
• Residential disability services (under 65s) – 23.3 SLTs to make homes safe to eat and communicate in 

These are targeted, specialist roles where small investments will prevent harm and reduce pressure in the broader health system. 

More SLTs in the system means: 

• Faster access to assistive devices that allow disabled people to communicate 
• Safer eating and drinking for thousands of people in residential care 
• People with dementia staying connected and independent for longer 
• Reduced hospitalisations 
• Better support for whānau and carers 
• Significant savings to Vote Health and Disability Support Services 

AAC devices and tools enable many disabled people to communicate, learn, work, and participate. 
But people currently wait more than three years for assessment, and over 1,600 people are on the waiting list.  SLTs are the only professionals who can design the personalised communication systems these devices rely on. 

Dementia affects 83,000 New Zealanders, and this number will nearly double by 2050.  Communication and swallowing problems are common among this community, but right now we have just 0.5 SLT FTE dedicated to dementia care in one region. 
SLTs help people stay connected, reduce hospitalisations, and delay entry to aged residential care. 

More than 6,000 disabled New Zealanders under 65 live in residential homes, most with significant swallowing or communication challenges.  Without SLT support, preventable choking events, hospital admissions and communication breakdowns are increasing. Funding 23.3 SLTs would ensure every home has proactive, regular support. 

No. The total investment is about $4.8 million a year, with a one-off year of extra funding for AAC waitlist clearing.  This is a tiny fraction of the health budget and will save money by preventing hospitalisations and reducing crisis-level interventions. 

Evidence from the position papers shows: 

• AT/AAC funding has a 4:1 social return 
• Delayed residential care entry saves tens of thousands per person 
• Preventing a single aspiration admission or PEG placement saves significant cost 
• Avoiding repeated ED visits in disability care reduces pressure on hospitals 
• Early SLT intervention reduces downstream crisis responses 

• Health NZ community SLTs are already overstretched 
• Disability sector SLT coverage is inconsistent and often absent 
• Education pathways rely heavily on TalkLink and lack sustained follow-through 
• Dementia SLT coverage is almost non-existent 
• Rural regions face chronic gaps 

Current structures are simply not designed to meet growing complexity or volume. 

We know there are gaps and shortages in speech-language therapy right across Aotearoa – in health, education, disability and aged care. This manifesto focuses on three priority areas for the 2026 election because they are places where a small, targeted increase in SLT staffing will make a big, measurable difference quickly. 
These three areas were chosen because: 

• The risks are high – people are currently missing out on basic safety, communication and dignity. 
• The fixes are clear – we know exactly what extra SLT roles are needed and where they would sit.
• The impact is system-wide – better support for AAC, dementia, and residential disability care will reduce hospitalisations, crises and pressure on other services. 

This is a first step, not the full solution.  NZSTA will keep working with Government on the wider SLT workforce shortage and will bring further proposals in future years as part of a longer-term plan. 

That communication and swallowing are essential to life and dignity, and the services that protect these functions are not optional extras. 
A small increase in SLT capacity in three high-need areas will: 

• Prevent avoidable harm 
• Reduce health system costs 
• Improve quality of life 
• Support whānau 
• Deliver equitable, culturally responsive care 

It is a practical, affordable and urgent plan.