Monday 4 March 2013

Reclaiming personal budgets from the bureaucracies

While I was carrying out the government's review into Barriers to Choice, one of the more peculiar aspects of the whole confusing choice agenda, is finding precisely what has been happening to personalisation.

The word choice is still embattled.  I sat with one group of doctors during the review who just stayed silent with their arms crossed in protest against the whole idea.  But ‘personalisation’ has always had the support of people and professionals alike.

The problem is that every time the innovations are rolled out that genuinely have some chance to give power to disabled people over how the money is spent to help them – local authorities so often move to undermine it.

There are huge exceptions to this, and councils which have really run with the idea.  But many local authorities have systematised the labyrinthine procedures, and have surrounded the business of providing direct payments and personal budgets with expensive bureaucracy, clawing back percentages as a matter of policy, adding approval committees and long lists of no-go areas or limiting choice using preferred supplier lists.

The result is that a big idea designed to give responsibility back to people on benefits - and to save money in bureaucracy at the same time – does neither in practice.

I struggled with the question of how to free up procedures, and help council officials to be a little less risk averse, given that the vast expense almost certainly outweighs the savings.  Setting out the intentions in legislation seemed unlikely to really break the log-jam since it is already set out pretty clearly, and that doesn't make a difference.  The way forward, I believe, is to signpost anyone claiming direct payments to where they can get advice – so that some of these extra-legal restrictions can be challenged.  In other words, by giving power to the people claiming money to insist.

It is also high time that these preferred supplier lists were phased out.  Councils should be able to have lists of their own suppliers – that is fine – but not use them to limit the way that people on direct payments can spend their money.  That locks people into suppliers who they may not like and who may not be able to provide them with the flexibility they need – and flexibility seems to me what choice is really about.

So I was so pleased to see a joint letter from a group of innovative disability organisations urging the Department of Health to back those recommendations in my review.

Fingers crossed on that.


Anonymous said...

What happens to the person if their "personal budget" is exhausted before the end of year etc?

Laura Newcombe said...

Fingers cossed indeed! As a broker i find that while local authorities/statutary bodies etc genuinely seem to believe that giving the power to the individual can provide much better outcomes, the inherent inbuilt paternalistic approach, albeit borne from both a desire to keep people safe and the legal requirement to meet needs, results in many adopting a half way approach. This results in oddities such as authorities only offering onternal brokerage, spendingmoney an market evelopment and then enforcing approved provider lists which exclude these new micro enterprises.....However, it remains m hope that the momentum that has been generated so far, coupled wih inititives such as yours, the open letter you mentioned and the work being done by TLAP will i said ....fingers crossed!

Matthew Richardson said...

That's a great initiative of that group of innovative disability organisations urging the Department of Health!