Backing for Scots plan to make direct payments default option

The social care sector is backing plans in Scotland to make direct payments the default option for care users.

The social care sector is backing plans in Scotland to make direct payments the default option for care users.

The Scottish government believes that if people had to opt out of direct payments – an unprecedented move in the UK – the current low take-up would be addressed.

The plan was included in a consultation on consolidating and developing legislation on self-directed support, published last week.

Under this, people would automatically be given a direct payment or a broader range of self-directed support options, such as a personal budget, that gave them control over their care but left its management with the council.

The Scottish government admitted the take-up of direct payments in the country was “fairly low”. England has about five times as many home care users as Scotland, but nearly 30 times as many direct payment recipients: 86,000 to 3,000, according to the latest official figures.

This reflects the political impetus provided by the UK government to further personalised care in England, most recently through the 2008-11 Putting People First programme, which is backed by £520m in development funding. This is now happening in Scotland too, through a self-directed support strategy launched in February, of which the legislative consultation is a part.

Currently, the law in Scotland places a duty on local authorities to offer a direct payment to eligible groups after a formal assessment.

The consultation paper said: “In reality, this means that the individual has a right to opt in to direct payments but that the traditional method of obtaining care remains as the ‘default’ position.”

It said service users sometimes lacked the awareness to make an informed choice.

Jeremy Cooper, director of public service consultancy iMPOWER, said “cultural change” would need to be engendered among care management staff to increase take-up of direct payments or personal budgets.

But Ruth Stark, professional officer for the British Association of Social Workers in Scotland, said the plan should even out self-directed support across the country.

She said: “Everybody has a right to it, but there have to be some guards there in relation to people who may not have capacity to instruct people and there will have to be some checks and balances there in relation to making sure people are safeguarded.”

Theresa Shearer, of service user group Enable Scotland, said the plan would widen direct payment take-up to beyond the vocal middle classes.

“It negates the almost elitist issues around it,” she said.

However, Ronnie McColl, health and well-being spokesperson for the Convention of Scottish Local Authorities, said: “On the specific issue of whether self-directed support should be offered as a default position, my personal view is that we need to be slightly cautious, particularly if this is expressed in the language of direct payments.”

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