A longitudinal study of the implementation experiences of the Australian National Disability Insurance Scheme: investigating transformative policy change

Helen Dickinson,Gemma Carey

doi:10.1186/s12913-017-2522-7

Abstract

BackgroundInternationally there has been a growth in the use of publicly funded service markets as a mechanism to deliver health and social services. This has accompanied the emergence of ‘self-directed care’ in a number of different policy areas including disability and aged care – often referred to as ‘personalisation’ (Giaimo and Manow, Comp. Pol Stud 32:967–1000, 1999; Needham, Public Money Manage 30:136–8, 2010; [Hood], [The Idea of Joined-up Government: A Historical Perspective], [2005]; Klijn and Koppenjan, Public Manage 2:437–54, 2000, Greener, Policy Polit 36:93–108, 2008). These reforms are underpinned by an idea that individuals should be placed in control of their own service needs, given funding directly by government and encouraged to exercise choice and control through purchasing their own services. A major challenge for governments in charge of these reforms is determining the best way to structure and govern emerging service markets markets. Given the growing international embrace of market-based reform mechanisms to provide essential services to citizens, finding ways to ensure they promote, and not diminish, people’s health and wellbeing is vital.MethodsThe Australian National Disability Insurance Scheme (NDIS) is Australia’s first national approach to the use of personalised budgets. The program of research outlined in this paper brings together streams from a range of different studies in order to investigate the implementation of the NDIS longitudinally across different administrative levels of government, service providers and scheme participants.ConclusionThis programme of research will make a contribution to our understanding of the Australian scheme and how individualised funding operates within this context, but will also generate much needed evidence that will have relevance to other jurisdictions and help fill a gap in the evidence base.

Highlights

There has been a growth in the use of publicly funded service markets as a mechanism to deliver health and social services
Faced with a range of fiscal and social pressures, industrialised countries are moving away from the collective social provision that drove the development of post-war welfare states [1] and which functioned as a social safety net, providing a range of services and financial assistance directly to citizens [2]
* Correspondence: g.carey@adfa.edu.au Public Service Research Group, University of New South Wales: Canberra, Nothcott Drive, Canberra 2600, Australia. In response to these various pressures we have seen the increasing use of markets as a mechanism to deliver welfare services and the emergence of ‘self-directed care’ in a number of different policy areas – often referred to as ‘personalisation’ [3,4,5,6,7]. These reforms are underpinned by an idea that individuals should be placed in control of their own service needs, given funding directly by government and encouraged to exercise choice and control through purchasing their own services

Summary

Methods

The Australian National Disability Insurance Scheme (NDIS) is Australia’s first national approach to the use of personalised budgets. The program of research outlined in this paper brings together streams from a range of different studies in order to investigate the implementation of the NDIS longitudinally across different administrative levels of government, service providers and scheme participants

Conclusion

Background