Policy Press
Eight Possible difficulties
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Abstract
As the previous chapter has demonstrated, direct payments bring a range of tangible benefits which can enhance the choice, control and wellbeing of recipients. We have also seen how pressure for direct payments built up over a long period (Chapters Two to Five) and how organisations of disabled people were able to mount a sustained campaign for the new legislation to be introduced. As a result of this, direct payments are almost always viewed as an essentially positive policy measure, and have probably been subjected to less careful analysis and critical reflection than should perhaps be the case. While direct payments do bring a number of very real advantages for service users, there are a number of limitations and contradictions that workers and service users need to consider:
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Are direct payments the product of a government seeking to restrict public spending and introduce a flawed notion of consumerism into community care services?
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Could direct payments represent a subtle shift in the boundary between health and social care?
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Does the success of direct payments rely too heavily on the attitudes and training of frontline workers?
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Are direct payments schemes adequately financed and do recipients receive enough money to purchase sufficient care?
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Might direct payments lead to the greater exploitation of women?
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Could direct payments leave service users vulnerable to abuse or at risk of significant harm?
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Is there a risk that some authorities could use direct payments to distance themselves from service users they perceive as ‘troublemakers’?
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Are the practicalities of managing direct payments prohibitive?
Abstract
As the previous chapter has demonstrated, direct payments bring a range of tangible benefits which can enhance the choice, control and wellbeing of recipients. We have also seen how pressure for direct payments built up over a long period (Chapters Two to Five) and how organisations of disabled people were able to mount a sustained campaign for the new legislation to be introduced. As a result of this, direct payments are almost always viewed as an essentially positive policy measure, and have probably been subjected to less careful analysis and critical reflection than should perhaps be the case. While direct payments do bring a number of very real advantages for service users, there are a number of limitations and contradictions that workers and service users need to consider:
-
Are direct payments the product of a government seeking to restrict public spending and introduce a flawed notion of consumerism into community care services?
-
Could direct payments represent a subtle shift in the boundary between health and social care?
-
Does the success of direct payments rely too heavily on the attitudes and training of frontline workers?
-
Are direct payments schemes adequately financed and do recipients receive enough money to purchase sufficient care?
-
Might direct payments lead to the greater exploitation of women?
-
Could direct payments leave service users vulnerable to abuse or at risk of significant harm?
-
Is there a risk that some authorities could use direct payments to distance themselves from service users they perceive as ‘troublemakers’?
-
Are the practicalities of managing direct payments prohibitive?
Chapters in this book
- Front Matter i
- Contents iii
- List of tables and boxes iv
- Foreword vi
- Acknowledgements vii
- List of abbreviations viii
- Introduction 1
- History 5
- From indirect to direct payments I: Legislation 19
- From indirect to direct payments II: guidance and extension 33
- The progress of direct payments 49
- The experiences of different user groups 63
- The advantages of direct payments 85
- Possible difficulties 99
- Practical issues 125
- Conclusion: implications for community care 137
- Bibliography 141
- Appendix: Useful resources 161
- Index 165
Chapters in this book
- Front Matter i
- Contents iii
- List of tables and boxes iv
- Foreword vi
- Acknowledgements vii
- List of abbreviations viii
- Introduction 1
- History 5
- From indirect to direct payments I: Legislation 19
- From indirect to direct payments II: guidance and extension 33
- The progress of direct payments 49
- The experiences of different user groups 63
- The advantages of direct payments 85
- Possible difficulties 99
- Practical issues 125
- Conclusion: implications for community care 137
- Bibliography 141
- Appendix: Useful resources 161
- Index 165
