Get out of the back seat

    Some say that public transport is overrated. Who wants to squeeze
    onto a bus with lots of other people, all going to the same
    inconvenient “one-size fits all” destination, when driving yourself
    means you go where and when you like?

    Direct payments offer service users an unprecedented opportunity to
    drive their own care. But a new report from the Commission for
    Social Care Inspection suggests that some professionals would
    prefer their clients to stay in the back seat, where they
    belong.

    It concludes that “many thousands of people are being denied the
    chance to take control of their own lives because of a failure to
    properly implement the direct payments policy”. And the figures
    back up the argument. While hundreds of thousands of people are
    potentially eligible, just 13,000 are receiving them. True, the
    total has more than doubled since 2001, but from such a low
    starting point the increase is hardly impressive.

    In fact, what the latest figures demonstrate most clearly is the
    vast variation in the take-up of direct payments across different
    authorities. Why, for example, does Plymouth only have 14, while
    Leeds has 456? The rate of increase is also enormously variable –
    Hounslow has increased by 900 per cent since 2002, Barking and
    Dagenham has fallen by 12 per cent. What on earth is going
    on?

    The CSCI suggests that a combination of incompetence, lack of
    information, patronising attitudes and unhelpful paperwork have
    stalled the direct payments revolution. Certainly, many councils
    and individuals are daunted by the administrative tangle. But it is
    too easy to conclude that professionals simply don’t want to
    relinquish control or don’t think their clients are up to it. Many
    front-line staff – whose job it is to recruit new service users
    into the scheme – are entirely supportive of the initiative but
    lack the necessary support from above. Without a clear commitment
    from managers, direct payments will remain mired in confusion and
    apathy.

    The CSCI has called for a taskforce to work alongside councils to
    improve their performance, and is recommending “rewards” for high
    performers. Perhaps these initiatives will encourage councils to
    unlock the door to the direct payments vehicle. But service users
    in less enlightened authorities might have to adopt the Dukes of
    Hazzard approach, and hurl themselves in through the window.

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