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Policy & Politics: Making it personal

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Personalisation is squarely at the heart of current policy debate around adult social care. For the last 10 years the British government has been experimenting with moving away from assisting users through providing services drawn from a relatively short menu of possibilities. Personalisation gives users personal or individual budgets and allowing them discretion to determine how they think the money should be best spent to meet their own understanding of their needs.

From a policymaking perspective it is a fascinating development because stakeholders from very different perspectives feel able to support it. The market liberals see it as a means of introducing competition and choice into public service provision, while those more concerned with autonomy and dignity see it as a means of empowering service users. Those concerned about the size of the welfare budget see it as a more efficient way of achieving positive outcomes for those receiving assistance. With such diverse constituencies lined up behind it, it is perhaps not surprising that the personalisation agenda has momentum.

And this is the case despite the need for several notes of caution. First, there is the tension between the individualisation of welfare and society’s collective responsibility for meeting the needs of its population. Second, there are concerns that personalisation may be great for some but it is not necessarily beneficial for all recipients of social care – older people in particular. Third, the evidence that personalisation delivers cost savings and enhanced outcomes is promising, but by no means overwhelming. Some would contest it vigorously.

Debate about personalisation can also occur at a more conceptual level. Precisely what type of state intervention does it represent? It is not the sort of direct service provision that much of social care provision has traditionally been based upon, but at the same time it isn’t a pure income transfer of the type so beloved by economists. In a paper in the current issue of Policy & Politics Simon Duffy and his colleagues offer a framework for thinking about personal budgets as a conditional resource entitlements (CRE). The characteristics of such entitlements can be examined in relation to five dimensions: autonomy, flexibility, targeting, support and conditionality. The authors argue that the nature of the conditionality associated with personal budgets differentiates it from other types of CRE: the focus is less on how resources are spent and more upon outcomes.

Perhaps the most interesting aspect of this issue is what personal budgets might tell us about future directions for welfare. Here Duffy et al offer a brief discussion of three possible scenarios. First, personal budgets are a transition in the move towards pure income transfers. Second, personal budgets represent an optimal state – they represent the best of both worlds. Third, personal budgets represent a stage in the process of shifting greater responsibility for meeting need away from the state and towards the individual. These are all plausible futures. Which one is realised will depend in part on how we make sense of the agenda and how we narrate it. Whether we embrace it uncritically or whether we contest it. There is much still to play for.

Duffy, S., Waters, J. and Glasby, J. (2010) ‘Personalisation and adult social care: future options for the reform of public services’, Policy & Politics, Volume 38, Number 4, October 2010*

Alex Marsh, Management Board, Policy & Politics

* This article is only available to subscribers. If you are not subscribed and would like to read this article, why not sign up for a free trial at http://www.ingentaconnect.com/content/tpp/pap/trial

Also available: Direct payments and personal budgets: Putting personalisation into practice by Jon Glasby and Rosemary Littlechild

Policy & Politics: The practicalities of participation and deliberation

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History may come to define the current UK coalition Government as the government that ushered in the end of the welfare state as we know it. The government that forced through a fundamental reconfiguration of the relationship between the citizen and the state. It may well turn out that the British population like the principle of firm action to address the state’s fiscal problems rather more than they like the practice. That story is yet to play out fully.

A more positive aspect of the current political agenda is the emphasis upon localism and involvement. The government aims to move power out of Whitehall and down to localities, giving local elected representatives and communities more scope to determine their own future. The two parties that comprise the current Con-Dem government may value this policy direction for different reasons. Are we talking about a vision of state withdrawal and survival of the fittest? Or a more positive vision of enhancing social cohesion and commonality of purpose in the more fragmented and networked Big Society? It is difficult to identify a consistent narrative. But the parties’ interests intersect and we are expecting Localism bill to be laid before Parliament next month.

While greater local autonomy and accountability in decision making is laudable, it is not without problems. What are the practicalities of delivering on this agenda? Is it another case of something that many feel is fine in theory but less palatable in practice?

Much has been written about participation and deliberation in policy making. Much has been written about the challenges facing those seeking make it a reality. The news is, generally, not encouraging. This is well-trodden ground.

One aspect of the issue which requires greater exploration is how changing structures of governance interact with mechanisms to enhance participation and local deliberation. In a paper in Policy & Politics Robert Hoppe addresses precisely this question.

The paper aims to provide some theoretical reflections on the links between policy problems, the structure of policy networks and appropriate mechanisms for deliberation. It focuses on the practical ‘perplexities’ and dilemmas in running deliberative projects, highlight problems at each of the input, throughput and output/outcome stages.

Equally importantly in the current context, the author pinpoints power – or the ‘ironies of real power politics’ – as at the heart of the issue. Participation mandated from the centre runs the risk of simply being seen as a supplement to existing processes, without significantly altering the locus of control. While deliberation from the bottom -up runs the risk of colliding with the self-identity of those at the centre who see themselves as having the legitimacy to make the decisions.

The author holds out some hope that governance structures can be nudged in the direction of accommodating the views of a wider range of stakeholder and citizens. But there remains a tension between peaceful, collective “puzzling” over what do to and the ‘competitive and potentially violent mode of political interaction’ that is “powering”. A timely reminder of the complexity of the challenges in realising the potential of deliberation – and a suggestion that some of the more far-reaching aspirations for deliberation may be over-reaching in the face of the unavoidable subtle, and not so subtle, uses of power.

Hoppe, R. (2010) Institutional constraints and practical problems in deliberative and participatory policy making, Policy & Politics.

Alex Marsh, Management Board, Policy & Politics