Trends in Australian rehabilitation: reviving its humanitarian core

This paper discusses how vocational rehabilitation (VR) in Australia has been captured by economic concerns, leading to its failure to deliver promised outcomes. Both public and private sector VR in Australia have undergone significant changes over the last two decades. The demise of non-profit and socially-based rehabilitation in favour of fixed funding models (e.g., managed care or case-base funding), coupled with the growing emphasis on cost containment has placed many VR providers in an unfamiliar environment dominated by bureaucratic, legal, economic and political imperatives. Although it was expected that VR would address rising injury costs, its inability to do so has jeopardized its existence.

Ironically, it is economic imperatives that are now prompting the re-invention of old concepts that appear to offer the same cost-containment possibilities rehabilitation offered in the 1990s. The most significant among these trends are self-management, coordinated care, community rehabilitation and welfare-to-work incentives. Perhaps the major challenge now, however, is to define a new dimension for rehabilitation and capture the essence of these trends to ensure that they contribute to a possible revival of a model of VR that focuses on the client's broad social context and responds to client-centred goals.