What Went Wrong with Personal Budgets

What went wrong with personal budgets?

Dr Simon Duffy, of the Centre for Welfare Reform, at Newcastle Business School on 29th October 2015

Where did personal budgets come from?

Social care policy swings between the development of institutional services or efforts to return power to people

The Long Journey from Institutional Care to Citizenship

• Personal budgets are just one of a series of innovations that have emerged out of the efforts of disabled people, families and their allies to move from institutional ‘care’ into full citizenship.

• Personal budgets, like many similar innovations, are an adaptation for a system that is inherently unhelpful and dysfunctional. The innovation is an attempt to modify or mitigate the essential craziness of the prior system. The resulting jargon reveals the inherent instability and complexity of these disruptive adaptations.

What went right with personal budgets?

• After decades of tacit resistance self-directed support or “personalisation” emerged as a transformational ideal for social care (and other parts of the welfare system). It challenged the normative view of Government as a vast rational ‘purchaser’ of appropriate ‘services’.

• The individualisation of funding and the right to control that funding is now one new norm within that system.

• Disruptive ideas and examples of innovation emerged, including: higher levels of creativity, new forms of support and increased opportunities for personal or family control.

Where are we now?

• Burdensome - Growth in numbers using ‘direct payments’ - but no significant use of less onerous systems.

• Bureaucracy - Regulation, pre-paid cards and burdensome monitoring is growing - £ is still not seen as an entitlement but as a ‘gift’.

• Incomplete - Procurement and market ‘rationalisation’ by commissioners continues.

• Marginal - Public understanding is low and the value of citizen creativity is still not widely recognised.

• Cut - More than 30% cut in social care by 2015 - increased eligibility, means-testing and reduced budgets.

And…

• The official ‘commitment’ to personalisation continues and the idea has spread to health, education and children’s services. However, worryingly, recent challenges in the media were ducked by Government and politicians.

• In reality social care is crumbling and old ways of thinking are returning. While good people continue to work at this, and interesting innovations continue, the overall direction and momentum is negative. As an effective ideal personalisation (at least in social care) is dead.

What did I learn about change and innovation?

• Prior to 2003 - Government showed no interest in self-directed support (although direct payments were very important).

• 2003-2005 - In Control made self-directed support both ‘sexy’ and controversial.

• 2005-2007 - In Control and DH became locked in strange kind of conflict for leadership.

• 2007-2011 - £0.5 billion largely wasted on implementation of personalisation.

• 2011 - Today personalisation is still official policy, but Government policy targets disabled people for cuts.

1. Victory is often defeat - giving Government ideas is like giving power tools to toddlers.

2. Government doesn’t innovate - Government can’t risk innovation - so it is forced to cheat.

3. Citizenship can’t be gifted - waiting for Government to enable citizenship is self-contradictory.

4. It’s easy to solve the wrong problem - adapting to crazy systems can create crazier systems.

Why do we think an idea is safe in the hands of those whose interests it challenges?

“Individual Budget” is now a Government term, Simon - you

can’t use it any more.

• “You’ve got 10 minutes to explain Individual Budgets, but then you can’t speak.”

• “We’ve not fixed on your model of Individual Budget, we’re using different models - but pool all the data.”

• “The problem Minister will be making local Government to do it.” [Civil servant who had resisted reforms]

• “You know what my dream is - we could write the Green Paper.”

• “Of course Government will f@*% it up - it’s just a matter of how much.”

If you are powerful you can both define and declare victory

Citizens don’t wait for citizenship - they demand it

• Developing a complex RAS - instead of tackling the mistrust of managers for social workers.

• Proposing that people develop support plans - instead of tackling the mis-use of plans as contracts.

• Using the term ISF (Individual Service Fund) to describe provider-managed personal budgets - instead of focusing on flexible support.

Some of the wrong problems I’ve ‘solved’

Is it time to start again?

Do I have a ‘little heresy’?

Orthodoxy - It is the role of Government to set policy (i.e. to define the desired innovation) and for the rest of us to implement those policies. It is the role of the rest of us to ‘implement’ those innovations.

A terrifying image - Expecting Government to innovate is like taking a beautiful horse, killing it, turning it into sausages, reassembling a horse from the same sausages and then trying to take the sausage-horse for a ride.

Heresy - Genuine and valuable social innovations involve real and complex changes in behaviour. They require not just formal rule changes but also changes in human understanding and attitude. Most cannot be simply imposed by Government. Instead they must be developed, over time, through personal, peer and social change. They will evolve and over time will become natural and feel easy (they will disappear into the background). Government’s role is to create the basic framework for change - law, structure, governance and appropriate forms of redistribution of necessary resources.

Government can’t innovate… so we must.

This is why we established the Centre for Welfare Reform - to support social innovation & promote real social justice.

www.centreforwelfarereform.org

@CforWR

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