Policy shifts and drifts: From intention to implementation of Australia's National Disability Insurance Scheme

It is not uncommon that original aspirations of social policy go astray during implementation. Issues that are the focus of social policy are often tied to various competing social, political, and value positions, making them unfailingly 'wicked' and rendering the design and implementation of solutions inherently challenging. Such is the case with Australia's National Disability Insurance Scheme (NDIS), which has been plagued by implementation problems and criticised for straying from its original objectives and principles. In this article, interview data from 31 stakeholders identify perceptions of congruence of the NDIS with its original objectives and values during the decade since inception, particularly focused on decision-making of reasonable and necessary supports. The perceived shift from disability rights to fights for entitlements and changing narrative of cost containment is indicative not only of implementation challenges but the inevitability of ongoing value disputes that often plague complex social issues. At a time of major NDIS reform amid ongoing tensions and debates, goal clarity and better decision guidance remain critical for future policy design and implementation.Points for practitioners Perspectives from diverse stakeholders across Australia explore where and why the NDIS may have drifted away from its original values, especially pertaining to reasonable and necessary supports. While stakeholders identified cost, sustainability, and consistency as increasingly significant issues in NDIS implementation, initial rights-based and person-centred objectives envisioned during policy design were seen as retreating. The inherent value tensions and contestations within the reasonable and necessary criteria have been under-recognised and inevitably persist in NDIS implementation. Critical insights for future policy reform can be gained from thinking about implementation issues and understanding when and why good intentions wander off course.