New Round of Upheaval

Anyone hoping that social care would be spending a few quiet months
on the back burner in the run-up to a general election should
prepare themselves for disappointment. An innocuous-looking new
document from a quintet of government departments appears to
promise plenty more upheaval and challenge in the foreseeable

Improving the Life Chances of Disabled People commits a future
Labour government to revamping the way services are provided to
disabled people. It focuses on employment problems, promoting
independent living and helping families with disabled children.
Worthy, to be sure, but not exactly earth-shattering. But in the
depths of the paper lies a proposal that could change the way
social care is provided to millions of people.

This idea is personalised budgets. The paper proposes that almost
every eligible disabled person – and the definition used is about
the broadest imaginable, potentially encompassing 11 million adults
in the UK – should control their own individual budget. In other
words, direct payments on a grand scale.

Crucially, these individualised budgets would not just pay for
social care support and services. They will encompass all budgets
that pay for different types of support needs.

The government seems committed to making this plan a reality and
there is some good sense underlying it. But, true to form, the
document is long on rhetoric and short on detail. It talks in
glowing terms about direct payments schemes without acknowledging
the significant problems many of them still face. It proposes
enormous change, yet offers no extra cash, and fails to mention the
pile of administrative and budgetary spaghetti someone will need to

Finally, the document exhibits masterful understatement when it
says the new system “would require a cultural shift” in the work of
social care professionals. Exactly where they fit into the new
order is unclear. One suggestion is that they will be “brokers”,
offering support and assistance to people as they decide how to use
their budget. Others might hold the purse strings as care managers,
or commission services for budget-holders to pick from. Either way,
it is one more respect in which the future for social care, and for
local authorities, looks a little different from here on in.

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