Institutional Legacies and “Sticky Layers”: What Happens in Cases of Transformative Policy Change?

Personalized care and market-based approaches to public service provision have gained prominence in a range of Organisation for Economic Co-operation and Development countries. Australia has recently joined this trend, launching a complex and expansive programme of individualized care funding for disability through the National Disability Insurance Scheme. Public sector markets (i.e. where governments either directly fund a market by way of competitive tendering, or through personal budgets) have been embraced by actors at different points of the political spectrum and for a range of reasons, including efficacy and efficiency gains, empowerment of citizens and efforts to cater for diversity. Despite the growing dominance of public sector markets and individualized funding, many questions about the role and responsibility of governments in managing and regulating these markets remain unanswered. In this article we outline different roles governments might assume in the creation and management of public sector markets, based on the types of risks governments are willing to take responsibility for. We argue that to fulfil the social contract between government and citizens, governments need to ensure that markets are properly stewarded and embedded in broader social safety nets. This, we contend, can ensure citizens receive the gains of market models while being protected from market failures or market-produced inequities.

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“…However, during implementation this shifted to the DSS on the basis of it having greater implementation experience (Carey et al . , forthcoming).…”

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confidence: 99%

The Vexed Question of Market Stewardship in the Public Sector: Examining Equity and the Social Contract through the Australian National Disability Insurance Scheme

et al. 2017

Self Cite

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“…The scheme aims to increase both funding and access to services and support for people with permanent and significant disabilities and the control that people with disabilities have over the design and delivery of their care, and frames this not as welfare, but as insurance underpinned by actuarial analysis, economic modeling and human rights (Miller and Hayward 2017, 130; Productivity Commission 2011; Australian Government 2013, 4), It involves a shift from Australian governments block-funding disability services to a personalized service model, in which packages of funding from a single pool are allocated to eligible individuals, according to their level of need and self-defined goals, to purchase services and support from providers under a range of conditions. Implementing the scheme calls for actions and engagement across multiple organizational and individual domains, testing the capacity of government, its agents, public and private service providers, community partners, people with disabilities and their support networks to process information and to find new ways to interact (Carey, Kay, and Nevile 2017;Carey, Dickinson, and Olney 2019;Hill and Hupe 2009;Klijn and Koppenjan 2000;Rhodes 2007).…”

Section: Introductionmentioning

confidence: 99%

Australia's New National Disability Insurance Scheme: Implications for Policy and Practice

Olney

Dickinson

2019

Policy Design and Practice

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Australia is immersed in its largest reform of disability services in a generationthe staged rollout of the National Disability Insurance Scheme (NDIS). Enacted swiftly to capitalize on rare bipartisan political and public support, the $AU22billion scheme promises to design and deliver disability services differently, with emphasis on service user choice and control. However, the scheme's rollout is outpacing the readiness of service users, service providers and the agency charged with implementing it to achieve its stated aims, threatening to derail it. Research suggests issues arising in the implementation of the scheme can be attributed in part to the design of the policy and, in part, to how it is translated into practice, both making scant reference to lessons from comparable reforms. Reflecting on the implications of these findings for policy and practice, we explore a range of challenges that arise when embarking on large scale reform in an environment of tight timelines, high expectations, extant policy silences, competing priorities, and jurisdictional ambiguities. This paper adds to the growing body of literature on the NDIS by bringing in the views of participants, and elaborating on implementation challenges posed by its governance structure, system architecture, and administrative structures.

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“…Some studies have tried to explain stability and change in policy-mixes. Using broad contours of arguments developed by Howlett and Cashore (2009) see Table 1 change in policy-mixes is explained through the processes of replacement, drift, conversion, and layering (Carey, Kay, & Nevile, 2017;Howlett & Rayner, 2007Kern & Howlett, 2009;Kern, Kivimaa, & Martiskainen, 2017) These processes result in policy packaging, when instruments are discarded, and new instruments are introduced; or in policy patching and stretching which involves restructuring existing policy tools rather than proposing completely new, alternative arrangements (Feindt & Flynn, 2009;Howlett & Mukherjee, 2018).…”

Section: Policy Tools Mixes and Their Attributesmentioning

confidence: 99%

Assessing health reform: studying tool appropriateness & critical capacities

Bali

Ramesh

2019

Policy and Society

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The past two decades have witnessed unprecedented policy effort to improve access to medical services and strengthen financial protection from catastrophic healthcare expenditure. Despite billions of dollars in health spending, manyespecially across the developing worldcontinue to remain vulnerable to financial impoverishment. What accounts for this poor performance? To respond to this question, we turn to the design literature in public policy, which emphasises the role of policy tools or combination of tools in addressing a social problem. In this paper, we focus on two interrelated aspects of the design orientation to explain outcomes: a) the appropriateness of the policy tool and b) the capacity of government agencies. We apply a framework, which integrates vital questions on both these aspects along three common dimensions (analytical, operational and political) to assess healthcare reforms in India and Thailand. The case studies illustrate the importance of both these aspects of the design orientation in explaining outcomes, and show how they are commonly overlooked in the health and social policy literatures, and in reforms underway.

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Institutional Legacies and “Sticky Layers”: What Happens in Cases of Transformative Policy Change?

Abstract: Institutional legacies and 'sticky layers': what happens in cases of transformative policy change?

Cited by 31 publications

References 25 publications

The Vexed Question of Market Stewardship in the Public Sector: Examining Equity and the Social Contract through the Australian National Disability Insurance Scheme

The Vexed Question of Market Stewardship in the Public Sector: Examining Equity and the Social Contract through the Australian National Disability Insurance Scheme

Australia's New National Disability Insurance Scheme: Implications for Policy and Practice

Assessing health reform: studying tool appropriateness & critical capacities

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