Building on the original strengths of direct payments to create a better future for social care

Abstract

Confidence in the prevailing In Control model of personal budgets in the United Kingdom is beginning to waver. This raises the question of ‘where to next?’ for social care. Will we be returning to the monolithic system that typified services at the turn of the millennium – a system that is deeply oppressive for the great majority who lack the support and confidence to escape it by accessing a direct payment to manage their own support system? The Care Act has made no change to the basic process whereby it is councils that will decide what a person’s needs are, which will be met and with what resource. However, we argue here that the situation is far from hopeless. In Control’s analysis, while attractive to a neo-liberal political ideology, was based on a serious failure to understand the reasons for the success of direct payments. Whilst policy-makers saw it as a triumph for consumerist notions of choice, it is better understood as a triumph for needs-based planning, but carried out in a person-centred way. Learning the right lessons offers a new way forward to deliver a respectful and flexible service within the context of the Care Act.