(Note: This is my personal website, so these represent personal views)
Some leading charities yesterday issued a warning about Personal Budgets, claiming that they could be a means by which Local Authorities are hoping to save money.
This has really riled me.
The social care system is under immense pressure at the moment: huge current demand, massive future demand, huge funding pressures anyway, and significant cuts about to make themselves known (if they haven't already).
And, in amongst this, the personalisation of adult social care amounts to one of the biggest public service reforms of the last decade.
This personalisation has taken many forms, but one key form has been the introduction of what are known as "Personal Budgets". Under this reform and put very simply, instead of the Council using its budget to pay for services that people can then take or leave, an individual is allocated an amount of money that will meet the needs the Council has assessed the individual as having. The person can then use this money as they wish to meet their needs.
It's not an understatement to say that this revolutionises the way social care is provided. At the simplest level, it means that an individual has far more choice and control over their social care than the Council arranging it on their behalf. Undoubtedly, there are challenges with Personal Budgets on a number of levels, not least of which is ensuring that everyone of every impairment type can benefit from them. But in principle, I fully support them.
So when well-known disability and care organisations suggest that Personal Budgets are a means by which Councils are trying to make cuts, it bothers me.
Of course, I live in the real world. I understand the huge pressures that the social care system faces, and I know that Councils may put balancing their own budgets before meeting the needs of individuals.
But the key point is this: the financial pressures that Councils face are the same pressures they'd have faced whether personalisation happened or not.
My question to the organisations who have issued their warning - and who are part of a large number of familiar organisations almost constantly issuing press releases and statements on the topic of social care, as if they were disinterested representatives of service users - is this: would they rather the cuts to social care happened in an unreformed social care system, or in one that places choice and control at its very heart?
Good article Rich. Personal Budgets is an area I have been working on in a consultancy role as well as being a service user. It is such a typical case of ideology vs pragmatism. I feel councils do see it can lessen their budgets but with the theory of better outcomes for the service users. A mass communications exercise is needed to dispel myths and promote how this reform of social care 'can' work for all.
Martyn, thanks for your comment and I'm totally agreed with you about the idea of how important communications is too all this. Of course, one major difficulty is that social care just isn't a "sexy" topic, and until there's either a personal need or something that happens in someone's family, no one really gives it any thought.
When Councils have to spend so much time defending their decisions around cuts etc., it's no wonder they don't have time to promote the virtues of personalisation.
I think it is an easy idea to sell to the general public but more of an effort actually needs to be made to 'sell' the idea to professionals who may still hold some of the keys to access. I have a lot of concerns with the way the roll-out has been implemented and I think the current system is inherently discriminatory because it was not planned through properly and seems not to have drawn on any of the lessons learnt in the roll-out of direct payments. I don't want to be a Cassandra-type figure as I think the general goal is fantastic but we (in local authorities) have been presented with unrealistic tools and have been fed unrealistic expectations - especially in older adults services where the budgets are much much lower than in services for adults of working age.
That's more or less a moot point now because money is running out and the way that the personal budgets have been pushed through to be 'zero-cost' means that in effect, there will be the cuts that would have been happening anyway, affecting the eventual budgets delivered.
It is frustrating beyond belief.
Of course, the cuts have come at a bad time for the personalisation agenda and people will draw a parallel - even if the two are completely different strands. However for the changes to be effective and equitable across all user groups, there needed to be additional money put in. Quality costs.