I have written before in this blog about personal budgets for social care. This afternoon, at a 2020 Public Services Trust event here at the RSA, we had an interesting presentation on this issue from Richard Humphries, Senior Fellow at the King’s Fund.
He made four points:
• The role played in the emergence of personal budgets by campaigning organisations of disabled people. A council chief executive at the meeting said that he believes councils have a role in setting up social movements of this kind to help challenge inertia and professional resistance to change.
• The very slow spread of personal budgets. Still, thirteen years after they were first made possible by legislation (and despite support from Government and opposition parties), only about 5% of social care spending is delivered through personal budgets.
• The importance to making budgets work of the infrastructure of information, advice and support to budget holders. (However, this point was put in question by Peter Gilroy, Chief Executive of Kent CC, who said more and more of his county’s clients prefer to simply receive their entitlement on a payment card and be left free to decide for themselves how to spend it).
• The need for personal budgets to be implemented in the context of a wider consideration of the relationship between citizen and state. Personal budgets raise issues about rights, responsibilities and reputations. The evidence seems to suggest that the councils that have made the most progress (such as Oldham, which channels over 50% of its social care spend through budgets) have done so because they have seen the policy as part of a wider strategy of personalisation and empowerment.
Although the evidence is still limited, Richard also confirmed that personal budgets appear to be popular with clients and a better way of getting money spent on the things that people care about rather than bureaucracy.
Personal budgets may in time prove to be the most radical shift in public service delivery of recent years, with major implications for other services. Over the next twenty years I expect more and more public services to be delivered through budgets directly or indirectly devolved to service users.