I’ve been trying to digest the green paper on the future of adult
social care, Independence, Well-being and Choice, and its sister
publication, Improving the Life Chances of Disabled People, hoping
that I would be witnessing some genuine joined-up thinking.
On first reading, the proposals seem coherent. The broad statements
about combating disadvantage, discrimination and inappropriate
service provision, and the understanding of disability that lie
behind these, are easy to agree with.
The idea of individual budgets, intending to give service users and
their families more autonomy and choice, would appear to free us
from the shackles of provision-led social care. In its place,
people will choose the services they want. They may purchase from
statutory provision – which will have to be responsive to demand –
or make their own arrangements, which means using the private or
not-for-profit sector. So adult social care becomes increasingly
market-driven, and service users become consumers and small
It is estimated that 95 per cent of service users won’t have the
resources to deal with this kind of responsibility personally, so
to guide individuals through this market-driven world, an
infrastructure of agencies and advisers will emerge. Organisations
like this are already being set up to help people use direct
payments. There is a good chance that we will simply be building
another level of bureaucracy; in effect, independent social
services, which will add to the overall costs, or eat into existing
Another proposal, given that caring is currently held in low
esteem, is to encourage social care career development and
training. This isn’t a bad thing, in providing a workforce with a
greater awareness of service users’ rights and needs. On the other
hand, carers will expect – quite rightly – enhanced rates of pay
for becoming better qualified. Again, training and qualifications
can only drive costs upwards.
There is to be no extra funding, so if any of these predictions are
correct, who’s going to foot the bill?