Independence setbacks

The Independent Living Fund enshrines many of the values proclaimed
by social care reformers in the past few decades. It acknowledges
the fact that disabled people usually want to live their lives with
independence and dignity, supported by families, friends,
neighbours and others in their localities. “This will continue to
be the primary means by which people are enabled to live normal
lives in community settings,” said Sir Roy Griffiths in his seminal
1988 report Community Care: Agenda for Action. “This,” he
added, “is as it should be.”

In many ways the troubled history of the ILF reflects the mixed
fortunes of care in the community as a policy. The policy triggered
by the NHS and Community Care Act 1990 was supposed to be needs-led
but proved instead to be cash-limited as the high ideals quickly
turned to dust. The ILF, evolving in parallel, also began as
needs-led and soon became cash-strapped: it had to be reincarnated
as the ILF 1993 Fund and had a controversial ceiling placed on its
grants.

Now, thanks to a bizarre change in government policy prompted by
legal advice, people appealing against disability living allowance
rulings will have their ILF money stopped in the meantime. More
than 11,000 people using the fund could be affected and, since
payments may be in the region of £500 a week, the impact on
their care arrangements could be catastrophic. For some,
residential care will be the inevitable consequence.

Such setbacks make a mockery of the recent adult social care green
paper’s claim to be a champion of independence with its proposed
right to request not to go into residential care. They are of a
piece with the doubts that continue to surround the Supporting
People programme, which the government seems to decry precisely to
the extent that it actually promotes independence. At the same time
the number of local authority direct payments, while rising slowly,
still languishes at a miserable 20,000 or so.

The achievement of independence with dignity for all those who
could benefit from it will require a much more concerted effort
from government and its acolytes. It will require a health and
social care white paper that recognises the importance of both
sectors in promoting independent lives and – a more modest aim but
just as elusive – it will require a less ambivalent attitude to the
genuine merits of the ILF.