Following my previous blog on irony and the practical implications of localism, I have received a mixture of both applause and rebuke from partners and our members. On balance I think the post tackled some serious concerns which were always going to be hard to stomach, but isn’t that the point of a blog? I’ll try venting my spleen on a different issue today, another which is causing me much personal angst.
In 2006 the health white paper ‘Our Health, Our Care, Our Say’ formalised a commitment to expand existing trials of direct payment schemes. The paper heralded the opening up of public services, in this case health, and paved the way for a vast array of potential micro providers from a range of sectors to provide direct services to budget holders.
At the time there was much excitement within the VCS about the opportunities and potential challenges that PB brought. Transition was the biggest issue; how do we move from a funded service to a service dependent on demand without putting existing delivery at risk and having to put employees at risk of redundancy. How do we ensure that budget holders are aware of our services and informed and most importantly who will do the signposting to those services to ensure that providers are given equal and fair access to market.
Overtime all these concerns have become reality at one point or other but it is the impact of cuts and how this has affected service signposting that is now of the gravest concern.
Across the East Midlands I now have two reliable examples of local authorities controlling PB services to protect their own budgets and interests.
- In example 1, the authority has employed only authority staff to manage all signposting and due to budget cuts to the adult social care budgets their priority is to ensure that customers use LA services first as without this level of reinvestment the services and whole department will become unsustainable. This is the most basic manifestation of the problem.
- However in example 2, an authority has cut access to PBs from those with moderate to severe needs to just severe and where budget holders do not procure mainstream services in a 12 month period their budget is being judged as not required and is cut. This is happening regardless of whether services are being accessed outside the authority by other providers.
Do I blame the authorities? To be honest no! In a context of falling budgets and massive change, the desire to protect the ‘self’ will undoubtedly be high. This is in fact a national issue where a clear lack of foresight in policy development and the failure to embed policy across more than one Whitehall department has resulted in a closed model which protects the few when times are bad.
It would be helpful to inform future action on this issue if members could provide information on their own experience of personal budgets and direct payments. Please email to me at firstname.lastname@example.org.