Understanding NDIS policy process

2022 might be the most critical year for the Scheme yet. It is a federal election year, when voters will decide which policymakers will control the destiny of the NDIS and the direction in which the Scheme will head. I'm not just talking about the Scott Morrison versus Anthony Albanese or Bill Shorten versus Linda Reynolds battles. Those contests will suck up plenty of oxygen, but there is much more at stake than a political horserace. The destiny of the Scheme lies in the battle of ideas, in who can understand them, and in who can articulate them.

A recent book, The National Disability Insurance Scheme: An Australian Public Policy Experiment, confirms this. The reader will learn why the NDIS has been such an essential policy from both a bureaucratic and political perspective. Better still, the book evaluates the public policy successes and failures that have characterised the Scheme over the past decade, placing them in a broader context. Understanding this wider perspective is why the book matters, particularly in light of the recent Scheme sustainability conversations. Not everyone has the time or inclination to do a deep dive on policy formulation and development. However, as DSC’s resident “politics nerd,” I loved reading the book so you don’t have to.

Edited by Western Australian academics Mahari Carden and Claire McCullagh, the book is divided into three sections. First, it provides substantial background on the formation of the Scheme: what came before it, how it was developed, and the key concepts that underpinned the policy framework. The second – and by far best – section analyses and evaluates how the Scheme has been implemented, focusing on specific issues and stakeholders. The book’s final part allows participants to express their opinions on the first decade of the Scheme, highlighting what has worked, what has not, and detailing future points for consideration.

A Public Policy Context for the NDIS

The qualities that make this book so effective are the same qualities that are foundational in public policy evaluation. The study of public policy can always be boiled down to one simple but profound question: “Why?” In more detail, these questions can include:

• Why is the policy necessary?
• Why are parts of the policy working?
• Why are parts of the policy not working?

It is necessary for participants, advocates, service providers, and allied health professionals to constantly ask how the NDIS works as a policy, but not necessarily why. Often, the question of obtaining the best outcome for the participants is the only one that matters for people doing the grunt work every day. By contrast, public policy practitioners have the luxury of avoiding “how” questions and asking “why” questions instead to examine policies from a wider perspective.

The book does a great job of getting to the “why” questions when discussing the NDIS. In this regard, three chapters are particularly worth noting.

Implementing Policy

The eighth chapter, “Implementation Challenges of the NDIS” by Gemma Carey and Eleanor Meldon, asks why the NDIS was such a complex policy to implement. The chapter commends the Productivity Commission for developing such strong governance principles but argues that these principles are difficult to maintain in an evolving policy process. It struck me that these same issues could also be applied when discussing the difficulties that participants have faced with the planning process on an individual level. As with the policy development process, a planning conversation is structured to capture a single moment in time and does not generally examine how that situation may evolve in the future. Both processes ask experts to forecast possibilities and make far-reaching decisions for an uncertain future. If a reader wants to understand why it is a struggle to translate the NDIS framework into practice, this chapter is a must.

Intellectual Disability and the NDIS

The chapter by Christine Bigby exploring how people with intellectual disabilities interact with the Scheme is also essential reading. As someone with a physical disability who has little contact with participants from this cohort, I found this chapter particularly enlightening. Bigby argues that the Scheme did not account for the multidimensional challenges of those with a range of intellectual diagnoses when the NDIS was being formulated. This chapter was also the strongest in articulating an overall theme of the entire book – that the Scheme has severe limitations if participants do not have the opportunity to actively participate in conversations that direct their goals. Crucially, this point is captured via a quote by an anonymous federal bureaucrat who suggests that the experiences of those with intellectual disabilities were underrepresented in the policy formation process because it is challenging to capture their views. To paraphrase the musical Hamilton, Bigby argues that people with intellectual disabilities want and need to be in the room where NDIS policy decisions happen. She also goes a step further and stresses why this is so important for the Scheme’s overall success. This is a study of policymaking with good intentions that can lead to unintended and unexamined consequences.

Not-for-Profits and the NDIS

Finally, the best chapter in the book comes from a contribution I was not expecting. In the chapter discussing the relationship between the not-for-profit sector and the NDIS, Penny Knight delivers a withering attack on the current failures of the Scheme in clinical and straightforward terms. Knight argues that policymakers and the Agency have to recognise that

1. The NDIS is not a proper marketplace.
2. Providers are not inefficient.
3. Human need cannot be commodified.
4. The NDIS is not the solution to solve every problem in the disability sector.

 Those who operate at the coal face of the Scheme on a daily basis may be well aware of some if not all of these criticisms, but the structure of this chapter and the points made are so clear that they are impossible to ignore. From a participant perspective, these criticisms resonate loudly.

Who This Book Is for and Why That Matters

Despite all this excellent content, the book’s broader intent seems unclear – perhaps it is targeted at the wrong audience. This book would be very useful for a reader who is working for a provider and struggling to understand why the NDIS operates in such an idiosyncratic manner. 

Despite this, the book is inexplicably challenging to obtain. It seems pitched to policy nerds. In particular, the first section is designed as background for those who have the most cursory knowledge of the Scheme, so it can be used as an academic example when teaching how public policy theory works in practice. These limitations are a shame because the content can and should be easily digested beyond the halls of academia.

The Scheme is at a crucial political turning point, and the disability sector needs to reckon with the possible implications of what lies ahead. Reading this analytical assessment of the NDIS policy process is an ideal place to start.