Is It Only Me?
Is it only me ... who hoped personal budgets would be a part of enabling people with disabilities to plan, organise and fund what they needed?
... who hoped that under personalisation social workers in Adult Care could return to what the job truly was - helping people to understand their need and act as a bridge between them and resources in the community?
... who hoped that the funding from personal budgets would help create an avalanche of small scale enterprises close to people with disabilities, and often run by them, both creating services that were truly responsive to people’s needs and generating jobs?
So why is it going wrong?
To my mind the top four answers are these:
First, much of the welfare state grew out of the ruins of World War 2. The main architects of the welfare state wanted it to bring people together. At a practical level they knew the failings of a patchwork of tiny voluntary organisations couldn’t cope with the volume of human need. But their bigger vision was of people who were citizens not just consumers, citizens in a welfare state not consumers of a welfare state.
Inadvertently, they helped create a monster. As the early years passed it was too easy for professionals to take exclusive control of a service (and thus gain status and money). And, let’s be honest, this suited a lot of people who weren’t welfare professionals too. For example, professionals found it easier not to have volunteers involved and people found it easier not to volunteer. And it was too easy for individuals to shrug their shoulders and say "The Government or the Council or the NHS should do something." The welfare state became something professionals did and something that other people received. Citizenship withered.
Second, all organisations forget what they are created for, and focus on their own needs: that is the pay and conditions of staff and managers. This is true of both the private and public sectors. In the private sector we see firms that are no longer interested in products that people want or need (think of British Leyland cars) while managers and staff battled over money. Or the recent upsurge in Chief Executive bonuses even when their companies are losing money. In the public sector New Labour greatly increased public spending. However, too much of this money went creating – well, lots more highly paid managers.
That range of organisations and professions that together we could call ‘Adult Care’ are no different. There are exceptions. But I’ve seen too many people with disabilities not get the service they needed because staff and managers were not prepared to move out of their comfort zone. Personal budgets are a form of innovation and as someone once commented: Your innovation is a threat to my custom and practice.
Third, part of leaving it all to the Government or the Council or the NHS is that we lose the skills of working together. Skills that are crucial if you are a citizen in a welfare state but not important if you are a consumer of the welfare state. I sat in 'a meeting' recently with a bunch of public sector professionals, a meeting but actually no one was functioning effectively: they all talked at once, or couldn't stick to a topic, or took phone calls, or ignored what others were saying, one person talked over the group and then abruptly left. There was no ‘baggage’, no controversy, little at stake yet the possibility of them agreeing a collective stance on the smallest thing was zero. What would happen if they faced a real task? Oh, like thinking about how adult care could be delivered better?
If we cannot read or write we call it being illiterate and we are both vulnerable and at a huge disadvantage in society. We are illiterate in the skills of working together. We are both vulnerable and at a huge disadvantage.
Fourth, in recent years life has got very complicated. Recently I bought some clothes on the web. (My local shop had closed). Instead of simply paying the money and taking the goods I had to tick a ‘terms and conditions’ box before I could proceed which opened onto fourteen pages of legal contract – for just under £40 of purchase. Pensions, utility contracts, credit checks, security on the web are all complex issues that twenty years ago no normal person had to deal with. We could call this ‘the life skills set’. No wonder then if you acquire a disability, or care for someone who has, as multiple agencies need to be dealt with and as complexity increases you are pushed over the edge.
In short what it means to be a citizen has become completely disconnected from our understanding of welfare. We’ve become too dependent on ‘welfare’ and not dependent enough on each other. We’ve lost the skills of working with each other and increasingly failing to acquire the skills of living in an ever more complex world. No wonder the systems for supporting and empowering people with disabilities ain’t working.
So what can we do to change this?
Well both users and professionals have a role to play. Let’s start with three points for those who have paid work in ‘Adult Care’.
First, the most self-centred teams and organisations can change for the better. We know - we’ve been there. You will need outside help. But the first step is to admit you have a problem (or if you work in local government you can call it ‘a challenge’). No acknowledgement of problem – no progress.
Second, working in the public sector ain’t great at present. Unfortunately, it’s not going to get better. At least in your corner of service, doing things different to do them better is a way of feeling better.
Third, there is going to have to be genuine dialogue with people with disabilities, genuine dialogue not those PR stunts which often go under the name of ‘consultations’. In this dialogue people will say painful things to you. This is because they are true. You need to acknowledge this pain not block it out or forget it.
Fourth, users you have everything to gain and little to loose. Users and carers will need to come together to learn new forms of working together in achieving common goals such as developing new community resources and new life skills. At S.H. Barnett we will be exploring this. On the plus side, nationally this is already happening: the cuts in benefits and services are mobilising people. But not enough. Too many of us are still welfare consumers and not welfare citizens.
Finally, much of this stuff is accepted. Business Colleges study how businesses fail by being self centred, it’s been written about in the public sector too. Histories of the welfare state describe how it started and what it has become. But it’s rarely put together and even less translated into practical terms for us today.
Or is it only me…?
The publisher is The Centre for Welfare Reform.
Is It Only Me? © S.H.Barnett 2012.
All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.