With public money under increasing scrutiny, we have the makings of a lively debate on how personal budgets are spent, writes Geoff Ettridge (pictured)
Based on the public reaction to the abuse of public money by MPs and my recent experience at a meeting of my local involvement network (Link), it is clear more needs to be done to prepare the public (and press) for the realities that will come with the wider introduction of personal budgets.
Links aim to give citizens a stronger voice in health and social care service delivery and the meeting I attended featured an excellent presentation from the local authority’s social care procurement manager.
Through case studies and testimony, it was shown how personal budgets improved the lives of people whose previous option was to attend or not attend a day centre. The manager cited the case of a man who, on regaining his mental health, used his personal budget to buy a dog rather than attend a day centre. He reasoned the dog would provide him with companionship and make him go out, thereby providing him with opportunities to meet other people. In another example, a carer spoke of using her daughter’s budget to arrange for a personal assistant to take her daughter horse-riding. Although these examples made me feel good about what we were trying to achieve, there were dissenting views – “I would like a dog but can’t afford one” and “horse-riding!”.
Those of us with long memories will recall this reaction is not too dissimilar to the negative press coverage of schemes for young offenders which were often represented as rewarding bad behaviour with holidays and adventure.
Public spending pressure
With public spending coming under more pressure, it is likely that there will have to be greater debate on competing priorities. Dominic Littlewood, on BBC1’s The One Show, questioned the justification of public funds used to pay for a holiday in Spain for a disabled woman and her carer. He did accept that the planned holiday would cost less than a week in a care home but he still questioned whether this was a proper use of public funds when there were cancer patients being denied life-extending drugs.
I also believe it will not be long before morality issues will enter the debate. With the increasing number of younger people receiving a personal budget, it is only a matter of time before the tabloids pick up on public funds used to purchase sexual services. A documentary has already been aired on a group of young men with disabilities having a holiday in Spain that involved visits to a brothel. Although public funds may not be allocated specifically for the purchase of sexual services, anyone dependent on benefits are by definition buying them with public funds.
A contentious debate
The ideology of personalisation may be sound to professionals and user groups, but it will take on a new reality as more people have the means to procure support from “novel sources”. Set this in the context of increased pressure on constrained public service budgets and the increasing number of unemployed people and families living on benefits, who might begin to see some of the personalised support arrangements as publicly funded perks that they can’t afford, and we have the makings of a contentious debate.
Although I have no answers to what are complex political and moral issues, I do know that informed and balanced debate will not happen if it is driven by press revelations and “outrage”. The acceptance of personalisation will be a hearts-and-minds issue. So perhaps a key component of local authority transformation plans needs to be a communication strategy in which they and carer and user groups engage with the local press to develop a positive perception of personalisation before the inevitable negative stories begin to appear.
Geoff Ettridge is an independent adviser on care services http://www.yourcarematters.co.uk