Personal view of personal budgets

Just a quick link to an Guardian piece by a recipient of a personal budget. Go and read the article and then come back!

It’s always more interesting hearing about services and policy implementation from people for whom the services are created rather than from professionals who put the policies and the procedures together.

A few interesting snippets leapt out at me and I suspect it is partly because the way the implementation is different in different local authorities.

This point in particular

Every social worker is aware of how much political capital has been invested in personalisation by the government, and it cannot be seen to fail. So social workers cherrypick service users who they think will be the best candidates. Yes, prejudice and social bias even extends to disability.

When I asked my social worker what the drawbacks of personalisation were, he was candid. He admitted it was a process of self-selection. Only those who were erudite, well educated and well organised were encouraged to apply for personalisation and those who led chaotic lives – a euphemism meaning that anyone with drink, drug or mental health issues was not put forward.

While no doubt that was the case when some of the pilot schemes were running, now we have no choice whatsoever (quite rightly). Everyone assessed for a service is going to be receiving a personal budget. Everyone whose service is reviewed will be transferred to a personal budget.

This point raises one of my bugbears as well. I begged our implementation team to include people with more complicated needs on the pilot. I personally spoke directly to the project manager and explained that until the scheme had been piloted fully with people who did not have ‘straightforward’ needs, people who may not have the capacity to make full decisions about their own care needs and older people who might have the same high needs for services as a younger disabled adult  but with a LOT less funding available, we could not be able to create a system that worked across the board.

Of course, I was told that no, the pilot needs to be straightforward so we can work out the glitches.. THEN we will introduce some of the more complex aspects. The problem is that we have been left with documentation and assessments that are focussed on physical care needs while the mental health services were left behind as they were not involved in the pilot – being ‘more complex’.

So yes, the self-selection occurred (not in our team as we weren’t a part of the pilot – despite my pleas!) but it does not occur anymore – not in my authority. Now it is a blanket approach.

The part of the article that cut to the core was this, in my opinion

It is suitable for anyone who is organised, methodical and lucid, but it helps immeasurably if someone else is able assist on your behalf and make sure you are not making any accounting mistakes.

Honestly, that made my heart sink. Not because I am not thrilled for people like the writer of the piece who is, without doubt, getting an infinitely better service – but because it further sidelines people who are NOT organised, methodical and lucid and people who do not have someone else to assist on their behalf.

In an ideal world, independent advocacy both directed and non-directed would be a wonderful tie-in for those who need assistance with details and management and for those who might not have the capacity to manage some of the details – however costs are being cut. Our own advocacy services now have a massive waiting list. The expectation again falls on statutory social services and honestly, I don’t say this because I’m proud of it but because it is the reality, in the day to day workload, there will not be the time for a social worker or social work assistant to provide the same level of support putting together an individualised and personally focussed care plan – maybe there would be in a learning disabilities team but in an older persons’ team where a much faster throughput is expected – it’ll likely be the same usual agencies that are used for the same, usual tasks.

I see personalisation as a wonderful thing in theory. In practice is has made a lot of care much better for the ‘organised, methodical and lucid’. The massive challenge is how to ensure that equal and better services are delivered to those who are not ‘organised, methodical and lucid’. Those who do not have networks of support. My fear is that the funding will be siphoned to those who are better able to articulate their own  needs.

I promise I’ll try to stop with the personalisation posts soon. I get the feeling I’m being somewhat repetitive but they are very much on my mind at work at the moment as I’m running through a few and so I keep thinking of more reasons to be frustrated with the implementation (as opposed to the ideology which I support completely).

5 thoughts on “Personal view of personal budgets

    • That’s the key really. The goal should be choice. Lack of money will always be a limitation to choice as well.

    • Good point! – the personal budgets are available to all service areas so you would/should be accessing them.
      As I said, in my borough at least, everyone is being referred, including all eligible users of mental health services. We don’t have any of the selection basis discussed in the Guardian article.

      There is no question the two are mutually exclusive. My concerns remain primarily with those who are not able to articulate their needs who may lose out against those who are better able to manage ‘the system’ and currently, there seems to be a discrimination in the favour of those who are able to advocate for themselves or who have friends and family to do so.

  1. I think that’s the key point CB. My Authority always used to point to the fact that there would continue to be ‘traditional’ commissioned services alongside the new system, but the reality is this service would then become residual and therefore a much lower organisational, political and public priority.

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