Individual funding for disability support: What are the implications for accountability?

A range of different countries have experimented with the concept of individualised funding and self-directed support, particularly for long term care. With the introduction of the National Disability Insurance Scheme, individual funding looks set to be an area of future development in Australia. Individual funding is concerned with making the financial aspects of care more explicit at the level of the individual. Supporters suggest that it has the potential to transform paternalistic and inflexible systems into ones that grant greater power to individuals. The introduction of individualised funding also poses a number of interesting questions about accountability. The paper considers these accountability dilemmas and provides evidence from different national settings to illustrate how these accountabilities may manifest in an Australian context. The paper concludes by setting out a framework of accountability bringing together these different dilemmas to think about provision of care as a whole.