Value choices in a mixed economy of care: How politics shapes the implementation of complex social policies

Abstract

While social and public policy studies recognize the diversity of actors and processes occurring in the implementation of policy and the organization of public service delivery, analysis of the role of value pluralism in implementation remains underdeveloped. This article contributes to a more nuanced understanding of the relationship between value pluralism and organizational responses to value conflict by exploring the effect of politics on the value choices of senior public servants involved in the design and implementation of Australia's National Disability Insurance Scheme. Our analysis shows that politics may play an essential role in facilitating implementation of a complex social policy that contains a number of incommensurable values because successful politics allows these incommensurable values to co-exist and adaption to take place, thereby avoiding organizational dysfunction.

Burdensome Administration and Its Risks: Competing Logics in Policy Implementation

“…As noted in the background section of this article, the NDIS has been characterized by fear over cost blowout and a wide range of implementation challenges. As a result, there have been a number of political decisions which have altered the design and administration of the scheme (Carey, Kay, & Nevile, 2017; Nevile et al, 2018). For example, the NDIA was originally intended to employ around 10,000 individuals to support the planning and administrative aspects of the scheme (Whalan et al, 2014), but the federal government initially restricted the number of staff who could be employed directly to 2,500 (Nevile et al, 2019).…”

“…Hence, the scale and scope of change envisaged under the NDIS has resulted in a wide range of implementation challenges (Carey, Dickinson, et al, 2018;Malbon et al, 2018;Nevile et al, 2018Nevile et al, , 2019Olney & Dickinson, 2019). This article explores the impact on providers, with a focus on administrative burden and financial sustainability.…”

“…These issues cause significant challenges in and of themselves, but, as a number of participants also observe, the amount of "churn" in the system-a much commented on problem with the implementation of the NDIS (Morton, 2017b;Nevile et al, 2018Nevile et al, , 2019-also adds to this situation: "The ever changing policy landscape makes it difficult to provide a consistent service and increases the administration costs to an unacceptable level" (P157). It is not simply a case of providers needing to learn the new NDIS system, but to continue to relearn as new systems and practices and processes are put into place.…”

The art and science of non-evaluation evaluation

“…38 A sophisticated analysis of politics, in particular, is of practical benefit, not just in showing what actually happens in the real world, but because of the way politics can support the implementation of complex social policies that involve multiple, conflicting, yet interdependent, values. 39…”

The implementation of complex social policy: Institutional layering and unintended consequences in the National Disability Insurance Scheme

“…Under the old State or Territory government programs, people with disability had little or no choice about what services they received or who provided those services. For this reason, another fundamental design principle was ‘more choice and control’ for participants (Nevile, Kay, & Carey, , p. 1295).…”