Personal budgets – an update
I have written before in this blog about personal budgets for social care. This afternoon, at a 2020 Public Services Trust event here at the RSA, we had an interesting presentation on this issue from Richard Humphries, Senior Fellow at the King’s Fund.
He made four points:
• The role played in the emergence of personal budgets by campaigning organisations of disabled people. A council chief executive at the meeting said that he believes councils have a role in setting up social movements of this kind to help challenge inertia and professional resistance to change.
• The very slow spread of personal budgets. Still, thirteen years after they were first made possible by legislation (and despite support from Government and opposition parties), only about 5% of social care spending is delivered through personal budgets.
• The importance to making budgets work of the infrastructure of information, advice and support to budget holders. (However, this point was put in question by Peter Gilroy, Chief Executive of Kent CC, who said more and more of his county’s clients prefer to simply receive their entitlement on a payment card and be left free to decide for themselves how to spend it).
• The need for personal budgets to be implemented in the context of a wider consideration of the relationship between citizen and state. Personal budgets raise issues about rights, responsibilities and reputations. The evidence seems to suggest that the councils that have made the most progress (such as Oldham, which channels over 50% of its social care spend through budgets) have done so because they have seen the policy as part of a wider strategy of personalisation and empowerment.
Although the evidence is still limited, Richard also confirmed that personal budgets appear to be popular with clients and a better way of getting money spent on the things that people care about rather than bureaucracy.
Personal budgets may in time prove to be the most radical shift in public service delivery of recent years, with major implications for other services. Over the next twenty years I expect more and more public services to be delivered through budgets directly or indirectly devolved to service users.
Comments
7 Comments on Personal budgets – an update
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Rich Watts on
Mon, 23rd Nov 2009 6:51 pm
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Joe FD on
Mon, 23rd Nov 2009 7:25 pm
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Enterprise for a better world : Matthew Taylor’s blog on
Tue, 24th Nov 2009 5:37 pm
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matthewtaylor on
Wed, 25th Nov 2009 4:59 pm
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matthewtaylor on
Wed, 25th Nov 2009 5:00 pm
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Richard Humphries on
Thu, 17th Dec 2009 5:56 pm
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Adrian on
Sun, 30th Dec 2012 7:12 am
Thanks for this interesting post.
I work as a Director of a user-led organisation (ULO) based in Essex (ECDP). We provide a number of support services to around 2,900 people who have Personal Budgets (or their precursors, Direct Payments), as well as run a number of projects/workstreams to enable people to make the most of their social capital.
I was therefore pleased to see the role of ULOs highlighted in your post above. It’s right that they play a part in constructively challenging local authorities to engage with the personalisation agenda, of which PBs are a key component. ULOs also provide clear added value to individuals through their care and support journeys, particularly when it comes to harnessing peer-led support. A number of our staff have direct, lived experience of living on a Personal Budget, and we have a regular network meeting of individuals who are on a Personal Budget. For someone going through the PB process, or looking for ways of how to use their PB differently, such peer-led mechanisms are invaluable. For individuals contributing their lived experiences, this can often be the first step on a path to other opportunities (volunteering, employment etc.)
For me, the beauty of ULOs is that they operate on both the supply- (i.e. service provision for local authorities) and demand- (i.e. representing the voice of service users) sides. By effectively combining the two, they can uniquely ensure that personalisation, and the use of Personal Budgets, enables and supports people to achieve whatever outcomes they choose, ensuring all the the time the care system is based on people’s voice and lived experiences.
And since ULOs don’t just operate within social care but across all policy sectors (housing, transport, health etc.), it’s only a matter of time before they support a Personal Budget-type approach across those sectors (as seen, for example, in the current Personal Health Budget pilots).
I’m worried about using headline stats about the numbers/ percentages on personal budgets as a measure of success.
It is vital that personal budgets in social care or health remain a personal choice. We have experience in our family of councils forcing people onto direct payments by taking away the option of having a service provided. The authorities freely admit the aim is to reduce costs.
It is worrying if an idea that was supposed to be about empowerment and self-determination becomes a threatening, inflexible imposition on vulnerable people.
[...] enhance public sector productivity and performance (for example, the use of citizen payment cards as we discussed in a 2020 Public Services Trust seminar here [...]
Interesting Joe. You should talk to Richard at KF, especially as budgets move into long term health care. An inevitable and unavoidable issue is that if more people opt out of a service it can become non-viable thus taking away choice from people who chose to sue it. This is what markets do i guess.
Thanks Rich. This is a really interesting comment. I am snowed under at present but it’s something i hope to think and write about further in the future.
Joe – your comment helpfully illustrates a paradox about how you get real change in public services. Plenty of evidence that people want PBs, yet huge variation from one place to another. How do you get all Councils to offer PBs without the top-down target that, as you say, could take choice away ? Although 5% of people on social care PBs doesn’t exactly suggest lots of people are being browbeaten into having them. I agree totally that we need better measures of success for personalisation (an end for which PBs are one means of achieving). Do get in touch if you want to discuss further.
Here is a personal budgeting tool I found and which proved to be very useful to me: http://www.planthebudget.com
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