John Dalrymple, of the charity In Control has a somewhat bitter joke about self-directed support.
It is creating a fairer society by ensuring some people have a few more opportunities to control some of their support, by giving them payments, as long as they have “capacity” and agree to spend the way their council dictates, he says.
It wasn’t meant to be like this. Self-directed Support (SDS) was meant to transform the lives of disabled people by revolutionising their ability to manage their own care.
Rather than the state, or health services telling people what they needed, SDS was intended to give people the power to choose. Instead of state-ordered time slots for being helped with meals or out of the house, or imagination-free trips to the local shopping centre, they could choose whatever help they needed, where they needed it and by whom.
That’s the policy, that’s the law, but it isn’t happening according to a new report on SDS. Too many recipients are being told they can’t get control of their support, or can, but in limited ways.
Rather than the revolution in care that was promised, SDS has become just another service that is awarded as a ‘package’. People needing support are often only offered a limited version, perhaps using services from a narrow list of council-approved providers.
Why? Partly, the report says, because of how well the status quo resists real change. Local authorities fear handing over power both to service users, and to the non-council services people might choose. Wedded to procurement practices born in the eighties, they can’t see a different way.
Austerity has given SDS a reputation as a cover for cuts. The merging of health and social care has also taken some of the momentum out of progress on SDS.
What is the answer? Firstly, more people need to know about SDS, and what it is meant to guarantee: choice for disabled and elderly people to live the lives they want to. Then they need to demand it.
But ultimately, some of those people may need to go to the courts to secure what they law says they are entitled to, setting a precedent for themselves and for tens of thousands of others.
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