When direct payments were first launched, many service users were sceptical. Although it was being promoted as the way to empower service users, we saw the pitfalls in handing over responsibility for managing people and budgets to individuals and families who had little experience of managing anything.
If initial attempts to put direct payments into practice were anything to go by, funding authorities also saw their limitations; most, if not all of the early beneficiaries of direct payments were people with physical disabilities. The sensitive issue of whether many disabled people, particularly those with learning difficulties or severe mental health problems, had the capacity to take on this level of responsibility was barely mentioned, but without addressing these issues, only those who already had suitable skills could make a success of direct payments.
Some councils were willing to invest in support services offering advice, information and peer support. These offer help with payroll, recruitment and selection; individuals can take up as much, or as little, help as they need.
The National Centre for Independent Living (NCIL) and the Association of Directors of Social Services (ADSS) have negotiated a new protocol, which recognises the value of support services, and addresses the fact that people with mental health problems and learning difficulties have been poorly represented in the take-up of direct payments.
Significantly, the protocol also recommends that support services are developed as part of user-led centres for independent living: “…NCIL and ADSS believe that support services are often best provided by local user and carer-led organisations”. They recognise that existing local service user and carer organisations are often small and under-resourced.
Authorities are encouraged to ensure a level playing field in competitive tendering. As NCIL and ADSS state: “It is essential that strong representative organisations of service users and carers exist… [they are] an important component of high quality commissioning and a keystone in the increasing take-up of direct payments.”