Self-directed support and personal budgets - panacea or problem?

Description

Paper presented at 2010 JSWEC Conference. The present government aims to ensure that people who use social services are given personal/individual budgets with which they can directly purchase the care and support they need. Personal budgets are seen as the means by which services will be ‘personalised’ and designed to fit around the person who uses them, rather than the other way around. Increasingly, this is becoming the ‘default’ model as local authority Performance Indicators encourage councils with social services responsibilities to offer personal budgets to service users, and ‘traditional’ forms of service provision are discouraged. However, the evidence base to support the introduction of personal/individual budgets currently remains weak, with only a handful of published studies, which are of variable quality. Our paper reports on a large, quantitative study, using a quasi-experimental design, of the impact of self-directed support and personal budgets on people who use social services. It was carried out in an English shire county in 2008-09. Amongst other findings, the study found evidence of positive outcomes for people from most care groups, on a range of measures. However, like the Individual Budgets Support Evaluation Network (IBSEN) report (Glendinning et al 2008) the study found no evidence of benefit for older people who were offered budgets. Evidence from both studies raises questions about the appropriateness of personal budgets for some people as a means of achieving personalisation. We then focus attention on the socio-political ‘lineage’ of personal/individual budgets, considering more fully what the drive to personalisation tells us about the nature of citizenship and governance contemporaneously. We argue that personal budgets may offer a false prospectus to many people, not least firstly, by promoting market rights but actually diminishing social rights and, secondly, by proffering participatory forms of governance as a replacement for traditional representative democratic structures.