Thursday, 23 October 2014

My kind of high security

In my ‘Return of the Chunky Ninjas’ blogpost (http://chrishatton.blogspot.co.uk/2014/10/return-of-chunky-ninjas.html) a couple of weeks ago, I suggested the following:

Rather than having block contracts for big service providers, why not have guaranteed 10-year amounts for people’s IPCs (people could return some of their IPC if they thought it was too much, and there would be the option for the amount of the IPC to increase if necessary). The money always follows the person.



It got a bit lost in subsequent Twitter discussions, except for @neilmcrowther who commented  “imagine could make huge difference if someone got that age 14-24”

To be honest, I was a bit embarrassed that this thought had occurred to me some 20 years later than it should have done. But again, as @neilmcrowther commented “cos something that should be so intuitive runs completely counter to common custom?”

So, this is a quick blogpost to highlight this idea and hopefully get some discussion on it. Why do I think it could be helpful?

1) It could remove at one stroke a lot of the insecurity that people and family members have to experience about the amount of their personal budget, particularly in terms of arbitrary changes/cuts to the amount and the feeling of also having to justify yourself to the local authority/NHS all the time.

2) This security gives people the chance to really plan for the ‘imagined future’ (@sarasiobhan’s vital words), rather than being stuck in a perpetual, insecure present.

3) It places more power in the hands (both individually and collectively) of people, families and allies to shape what supports they want in their local area.

4) It also removes a lot of the petty and spiteful bureaucracy (I’m thinking particularly of the experiences of @MarkNeary1) that often seems to unnecessarily attend the way that local authorities administer personal budgets. Why not leave people to get on with it, with people simply producing a straightforward annual budget report every year?

5) It separates what should be a positive process of helping people work out what supports will work best for them from what is felt as a punitive process of deciding how much the budget should be, which I imagine would be a great relief to many social workers as well as to people and families.

Of course there are issues with this idea. The initial budget setting process obviously assumes huge importance. There also needs to be some way of checking for outright fraud that isn’t used as an excuse for bringing insecurity and spiteful bureaucracy back in (although how long can woefully underperforming/actively dangerous providers carry on with block contracts at huge cost?). Decisions need to be made about uprating the annual amount in line with inflation, whether any underspend is given back (without affecting the next year’s amount) or can be saved for later investment, and how the amount can be revised upwards as people’s needs may change?

If all this sounds too utopian and costly, I would ask you to consider the following:

Local authority returns and personal social services expenditure data suggest that there were 105,305 adults with learning disabilities subject to assessment/care management in 2012/13, at an average annual cost of £3,105 per person per year (my estimate is a total cost per year of £326.9 million). I think these proposals should drastically cut this expenditure.


I’ve been trying to do some estimates on the likely amount of NHS and local authority money being spent directly on adults with learning disabilities. At the moment (and there’s more work for me to do here), I reckon it comes to at least £6 billion per year. Surely much of this could be better spent?

Update: As @milton_damian and @MarkNeary1 have quite rightly pointed out on Twitter, this post assumes that people still have to prove themselves accountable to the state. They rightly argue that:
1) the state should have to prove itself accountable to people, not the other way round
2) Mechanisms of 'accountability' like those proposed above can be and are used as stickes to beat people with
3) Things like DLA, child benefit etc don't require such 'accountability'.

So - scratch that bit of the blogpost above!

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