BMC Health Services Research (Aug 2017)
A longitudinal study of the implementation experiences of the Australian National Disability Insurance Scheme: investigating transformative policy change
Abstract
Abstract Background Internationally 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. 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 This 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.