This chapter compares and analyses work under two social policies that claim to empower service users, recognize human rights and improve service quality, namely, the Social Care (Self-Directed Support) (Scotland) Act 2013 and Australia's National Disability Insurance Scheme (NDIS) (NDIS Quality and Safeguards Commission, 2018). Although both policies are seen as much-needed steps towards the social inclusion and human rights of people with disabilities, the private-market consumer focus and inadequate funding of these policies pit the rights of service users against the employment rights of care workers, generating a downward spiral in wages and conditions, as well as serious concerns about quality of care. Both policies place customer choice at the heart of care relationships, providing individualized funding packages to eligible individuals for the purchase of needed or wanted services.
These policies emerged during a time of heightened austerity and witnessed considerable concerns on the part of service users that their personalized funding packages were inadequate to their needs and that their views and those of their families and carers were often overlooked (Productivity Commission, 2017; Warr et al, 2017). This has obvious spill-over effects on service organizations, which receive inadequate recompense for services provided, and frequently experience problems with cash flow and shortfall, providing incentives to drive wages down and increase temporary and insecure employment.
In Australia, funding is assigned to the individual in a pay-as-you-go arrangement. This has propelled the rapid emergence of gig-like or casual, on-demand labour markets for individual home care workers in disability care, supplanting long-established, permanent, non-profit employment. Australia's system of employment regulation and sector-wide wage awards seems ill-equipped to protect workers in this new, fragmented context (David and West, 2017).
In Scotland, care organizations are required to pursue cost recovery from the government after individual services have been provided. For Scotland's voluntary sector, the requirement that funded agencies should adopt New Public Management (NPM) practice has resulted in a prevalence of short-term funding contracts, cuts in services, stricter and often confining performance criteria, and the emergence of a ‘contract culture’ whereby funders determine what type of care is available (Cunningham, 2014). It is ironic that under a policy aimed at consumer empowerment these trends create a greater emphasis on target setting over service users’ needs.