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|TX: 07.10.03 – HOW CAN WE IMPROVE SERVICES FOR PEOPLE WITH LONG TERM MEDICAL CONDITIONS?|
|PRESENTER: PETER WHITE|
Now over the last six years a gradual revolution has been taking place in the way disabled people's care is delivered. Since 1997 it's been possible for clients to receive money from social services, so that they can recruit and employ carers or personal assistants themselves, it's called direct payments and the idea is to give service users more choice and flexibility over how their care is delivered. Until direct payments came along all care was organised by social services directly and although almost 8,000 people now receive direct payments in England, not all local authorities have been equally willing to move to this idea. But in April of 2003 it became obligatory for social services to give direct payments to any disabled people who wanted them.
So six months on how well is the direct payment system actually working? Well the disability charity Scope has put together a survey of disabled people's experiences and found that not everyone is happy with it. Jane Muir chose to receive direct payments on behalf of her son Alistair, who's 12 and has cerebral palsy.
Before I'd always had respite care for one overnight stay a month, plus I had four hours a month relief to care, I think they call it, where somebody comes round to your house - that's one hour a week - big deal. Now they've said suddenly that I could have 26 hours a month, which I thought great, and then they said and we'll give you £1.30 an hour to pay somebody. And I just couldn't believe it. My son is quite severely disabled with cerebral palsy and to give me £1.30 an hour to pay somebody to look after him I just thought I'd be too embarrassed actually to ask someone to do it for that. So then I opted for the six hours a month instead which was at a normal rate, but that means I'm doing without my respite care.
Jane Muir. While Iris Hendry was receiving direct payments in the London Borough of Newham, the problems began for her when she moved to Kent, where she now lives.
I had difficulties when I moved from Newham to Kent. Did all the right things - gave them a month's notice in Kent that I was moving here and still it went wrong and it took until January to get an assessment by a care manager here. It then took a further three or four weeks to get the payments in place, it meant it was months rather than days or weeks before I knew that I could definitely keep all the staff I'd taken on. I did also have to put a thousand pounds of my money into that bank account because money was running out rapidly and five cheques were due to bounce.
Iris Hendry. Well I'm joined now by Richard Parnell of Scope and by Jeff Jerome of the Disability Committee of the Association of Directors of Social Services. Richard Parnell we've heard some criticisms there, first of all though what's the overall view of this first six months?
Well Scope research has found that direct payments can dramatically alter disabled people's lives and produce much greater amounts of choice, control and independence. For example, direct payments for disabled people can decide themselves when they want their personal assistant and who it is, when they want their respite care etc. So when it works well, it works very well and we're very positive about it.
So when it works badly why does it work badly usually?
Well I think one of the problems we have is sort of there's a time lag - the legislation's only been in since April 2003 and I think Scope's research shows that there's an uneven development within social services departments in England in respect of direct payments.
Can I bring Jeff in though because that's not really an excuse is it? I mean people have been doing this since 1997 and actually in some cases before that, so people couldn't say they didn't know how it worked.
No absolutely. Can I start by saying that we welcome this report from Scope and that the Association generally is fully in support of direct payments and their growth. There isn't an excuse certainly for local authorities to not be moving forward on direct payments, it has been in for some years now and the issue of unevenness, that Richard talks about, is something that we would expect to now be being dealt with. Certainly the better authorities have large numbers - I mean my own borough's moved from a small number of people early in the year, we've now got over 70 and we expect that our staff do assess people quickly and the sorts of examples that you've given so far in your programme should be dealt with by good liaison between different local authorities.
Can I ask you one key question Jeff? Are some local authorities trying to use direct payments as a way of getting the service on the cheap, in the way that Jane Muir seems to have experienced?
Well I'd hope not, I mean there's no reason at all …
But £1.30 an hour's ludicrous isn't it.
Yes £1.30 an hour is ludicrous and I wouldn't know which local authority that was but I'd be very surprised that anybody would offer that sort of money and certainly the example given, that particularly local authority will actually have found it more expensive to themselves to have then provided the service directly, so I'm bit surprised to hear that example.
Richard Parnell, what do want to happen? Presumably you clearly want an even system, how is the best way to get it?
Well I think one of the issues I think that's also contributing to the sort of uneven take up of direct payments by social services is a need for a cultural shift and I think there is a certain reticence amongst social services and maybe social workers that they should actually hand over responsibility to disabled people for running their own affairs, as it were. And in effect all direct payments is doing is putting disabled people who need services on a par with other families who already have that sort of control over their lives. So I think there needs to be that cultural shift in the attitude towards - between sort of clients and professionals.
Jeff Jerome quickly, do you think that's right, are some local authorities unwilling to trust, as it were, or don't believe that people can manage this properly?
Well hopefully they're a minority now and as I said the staff should be taking a different position and there should be support services independently set up in the better local authorities and hopefully across all in the future to help people to run direct payments.
Jeff Jerome, Richard Parnell thank you both very much indeed.
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