Cash for care under the NDIS: Shaping care workers’ working conditions?

Abstract

The Australian National Disability Insurance Scheme (NDIS) introduces a national cash-for-care model for disability support and care. The NDIS has been hailed as a significant advance in social care provision for people with disability, bringing both additional funding and choice and control. However, little attention has been paid to how the shift to a cash-for-care system will impact on the working conditions of disability support workers. The international literature suggests three main factors shape better or poorer employment outcomes for workers in cash-for-care schemes: the extent to which cost containment underpins scheme design; the regulation and monitoring of care delivery; and the regulation of care employment. In this article, we explore these factors through an analysis of the planning, design and initial implementation of the NDIS and make a preliminary assessment of how the new scheme might shape care workers' employment conditions.

NDIS Self‐Management Approaches: Opportunities for choice and control or an Uber‐style wild west?

“…). Workforce commentators have described the disability service industry as predominantly female and characterised by high turnover, underemployment, low status and under skilling (Productivity Commission ; CS&HISC ; MacDonald & Charlesworth ). Problems have also included: support workers being locked into minimum pay levels as defined by awards and/or Enterprise Bargaining Agreements with little opportunity for wage increase; irregular, short and/or uncertain work times outside normal 9 to 5 shifts; minimal avenues for career advancement; and, unpaid travel to and from jobs (Productivity Commission ; CS&HISC ; Cortis et al.…”

“…There is a lack of clarity within the “light touch” regulatory environment of the NDIS, where traditional checks and balances are being elided, regarding who is accountable for protecting conditions and human rights of both participants and the support workforce (Dickinson et al. ; MacDonald & Charlesworth :16). Risks include potential impacts on support quality, safety of service users and maintaining support worker conditions, security and pay (Dickinson et al.…”

“…Risks include potential impacts on support quality, safety of service users and maintaining support worker conditions, security and pay (Dickinson et al. ; MacDonald & Charlesworth ). Given the relationship between good working conditions and good quality support, the direct employment model poses additional risks to an already vulnerable and precarious workforce.…”

“…Given the relationship between good working conditions and good quality support, the direct employment model poses additional risks to an already vulnerable and precarious workforce. This group may become more disadvantaged as market forces dominate workforce supply and demand (MacDonald & Charlesworth ).…”

The work of care: tensions, contradictions and promising practices

“…issues faced by particular occupations in sectors including aged care, disability care and childcare (see for example, Meagher et al 2016), and specific policy initiatives such as the National Disability Insurance Scheme in Australia (Cortis et al 2013;Macdonald and Charlesworth 2016); or similar individual-based, cash-transfer policies in the UK, Canada and the US (Da Roit and Le Bihan 2010); to analyses of practices within individual sectors and workplaces. At a more micro level, there is increasing focus on the care relationship as a mediator of both job and care quality (McBride et al 2015).…”