How personalisation programs are exacerbating socio-economic inequities: findings from budget utilisation in the NDIS

Abstract Researchers and policymakers are increasingly concerned that personalisation schemes in social and health care might be worsening social and health inequities. This has been found internationally, where better outcomes from such schemes have been found amongst those who have higher education and more household income. This study looks at one of the world’s largest personalisation schemes, the Australian National Disability Insurance Scheme. It found that although the individual budgets provided within the scheme (which are a key feature of personalisation schemes internationally) do not present an equity issue, the ability of participants to ‘spend’ or effectively use these funds follows a social gradient. That is, those in low socioeconomic areas appear to be less able to spend their allocated budgets on care services. We argue that this points to the need to provide targeted supports for fund implementation in low socio-economic areas. Without effective supports for fund implementation, the NDIS is positioned to worsen existing social inequalities.