Direct payments for social care spark fears

The growing use of personal budgets and direct payments for social care may prove a way of quietly cutting services, a study published by Unison, the health service union, warns.

Labour has been pushing councils to introduce personal budgets and so-called direct payments, whereby individuals are given public money with which to buy social care.

All the political parties favour such services, which they say give people more choice and control. Recipients “use the money frugally and imaginatively”, according to Hilary Land, emeritus professor of social policy at Bristol University, and Susan Himmelweit of the Open University, the authors of the study.

There is also evidence that individuals receiving direct payments spend less than councils would if they provided the care.

But the study says there have been widespread variations in the amount local authorities give in direct payments.

Some have provided recipients with enough money to pay care staff above council rates, with others receiving less.

There have also been large variations in the amount spent supporting direct payments.

Given the forthcoming huge squeeze on public spending, “it will be easier for local authorities, and indirectly the government, to fail to raise direct payments and individual budgets in line with rising wages, than to cut services directly”, the study says.

This would push the problem of cuts in care onto recipients.

Personal budgets also raise problems for day centres and other forms of collective provision for the elderly, according to Professors Land and Himmelweit. “Some services directly provided or financed by local authorities may no longer be commercially viable on current funding,” they say. “Such collective forms of care bring benefits, including social contact, that it is difficult or impossible for individuals to produce through spending individual budgets on their own”.

Labour has set a target for 30 per cent of social care recipients to have a personal budget – which may nor may not involve a direct cash payment – by April next year.

As of April last year, only some 86,000 people from the 600,000 receiving social care in England were getting direct payments, with the payments accounting for about 4 per cent of the social care budget.