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Accountability in Public Service Quasi‐markets: The Case of the Australian National Disability Insurance Scheme
Authors:Eleanor Malbon  Gemma Carey  Helen Dickinson
Affiliation:University of New South Wales
Abstract:Australia's National Disability Insurance Scheme (NDIS) represents the latest in a worldwide shift towards individualised funding models for the delivery of care services. However, market‐based models for care deliveries bring new considerations and dilemmas for accountability. Drawing on previous work by Dickinson et al. (2014), we examine a range of accountability dilemmas developing within the early implementation of the NDIS. These relate to accountability for the following: care outcomes, the spending of public money, care workers, and advocacy and market function. Examining these accountability dilemmas reveals differences in underpinning assumptions within the design and on‐going implementation of the NDIS, suggesting a plurality of logics within the scheme, which are in tension with one another. The contribution of this paper is to set out the accountability dilemmas, analyse them according to their underpinning logics, and present the NDIS as having potential to be a hybrid institution (Skelcher and Smith 2015). How these dilemmas will be settled is crucial to the implementation and ultimate operation of the scheme.
Keywords:accountability  care provision  disability  individualised funding  market
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