Debate on direct payments for people with learning difficulties

We asked if people with severe learning difficulties
could benefit from direct payments if they are given enough
support.

These are the responses we received:

“Five months ago I came over to England from
Australia to work as a care manager with adults with a learning
disability. Western Australia has had direct payments for people
with learning disabilities for about the last 20 years. What they
have over there is a Disability Services Commission which assesses
and fund clients directly. The people who have the role of
assessing clients are called service coordinators. Over here they
are called care managers.

The advantage of direct payments is that clients spend their
money on the provider that can best suit their needs. In effect,
organisations which offer services for people who have a learning
disability are lining up at the ‘front gate’ to offer their service
to clients and their families. By operating this way I think it
really puts the client and their family at the centre of the
decision making process, which is what person-centred planning is
all about. Clients are able to change their care providers at any
stage. I think options and choices are the most important things
you can offer anyone wanting a service. Services operating in an
environment like I have been describing have to be innovative and
offer a service that people want or else they cease to
exist.”
Geoff Perks

“I am a social worker for adults with learning
disabilities and am a strong supporter of direct payments. Several
of my clients are now receiving direct payments. However, the
system to set direct payments up in the borough where I work is
very convoluted and time consuming. In a job where the workload is
already high and stresses unbelievable, it is a fair effort to
continue being positive about direct payments when it is
unnecessarily difficult to set up.
Also I am expected to play accountant and periodically check the
paperwork, and see how the money has been spent.  If money is
misused am I directly responsible and accountable?
The system appears to have been made deliberately unattractive to
put off social workers. I am not surprised take up is
low!”
Anononymous. frazzled social worker

“People with learning difficulties are often
not advised of the availability of a direct payment. One argument
that is used is that either people are too disabled to manage a
direct payment or not disabled enough to need personal care

The barriers to managing a direct payment are easily overcome by
setting up support systems like a trust or a circle of support to
manage the day-to-day work of the direct payment. For those not
needing a direct payment for personal care, it would enable them to
get out and about with the support of a personal assistant.

Given that direct payments could and do enable people to lead
more fulfilling lives, why are people with learning disabilities
still being denied access to direct payments? Could it be that the
authorities see it as an enormous threat to the day care services
already provided, which many people use because at present they are
not offered any alternatives. Direct payments would provide this
alternative, giving this group a chance to explore and take part in
mainstream facilities. 

It could also be argued that until the authorities re-think
their idea of day care they provide, making it more attractive to
the user group then it is likely that people will opt for direct
payments, and direct payments schemes are encouraging and
supporting people to do this.”

Julie Turner and Rosemary Green

Kingston Centre for Independent Living – Direct
Payment Scheme