Choice and control key to social care reform, Health Committee reports

06/07/2012

People should be given control over their own care budget, including being offered a direct payment to fund alternatives to council run care, according to a report by the Health and Sport Committee into the Social Care (Self-directed Support) (Scotland) Bill.

However, there is a major discrepancy in how much the Bill will cost to implement, with COSLA estimating that it could cost double the amount claimed by the Scottish Government.

Launching the report at a meeting of carers in Glasgow, Convener of the Health and Sport Committee Duncan McNeil MSP said:

“Our Committee supports the principle that people should have the choice as to how their social care is provided. However, this legislation requires fundamental changes within local authorities to deliver this.

“Our Committee is calling for confirmation from the Scottish Government that sufficient funding will be in place. However, it is completely unacceptable that the Committee has not been able to determine if the funding gap identified by COSLA is real or imaginary. It is vital for witnesses to be able to substantiate assertions made in evidence to this Parliament.”

 

After hearing from those in receipt of self-directed support already, Deputy Convener of the Health and Sport Committee Bob Doris MSP said:

“Our Committee has heard that this legislation can give people choice and control over how their care is delivered and the services that are most important to them.

“We have heard of many good examples of where self-directed support has transformed the lives of those receiving care and believe that the principles underpinning the legislation can help ensure more people have similar positive experiences.”

The report also concluded that:

• Without unpaid carers the health and social care system would be unsustainable;
• The flexibility offered by a direct payment can allow a person to take control of their care and meet their personal needs more effectively;
• The Bill will present a number of challenges, especially to the local authority, independent and voluntary sector providers;
• Due to the negative experiences of some people undertaking a reassessment for self-directed support in Glasgow, the Committee recommends that the Scottish Government ensure that the process is robust and not perceived to be a cover for cuts in funding;
• The Committee notes the concern about eligibility criteria set by local authorities and welcomes work being done to assess if there should be national thresholds for support;
• The Scottish Government should consider making explicit the principles of independent living on the face of the Bill.  

Background

What is self-directed support?

Self-directed support is a method of personalising the delivery of care services through ‘an individual budget’, where an allocation of funding is given to an individual after an assessment for support.  The individual can then choose to take it as a direct payment or can use it to choose services which their local authority arranges.

Supporting statistics

• Whilst current legislation does not prevent these options from being offered already, the Bill would place a specific duty on local authorities to provide self-directed support. 
• Based on detailed modelling, the Scottish Government is providing £23 million across three years to local authorities to help with transition. COSLA has given a conservative estimate that this will cost £50 million, but suggests that this could be as much as £90 million over the next three years.
• In 2010-11 England had an uptake of direct payments of 23.9 per 10,000 population, Scotland had just 8.4. 
• Nineteen local authorities have a rate lower than the Scottish average, with the Scottish Borders having the highest rate of take-up at 25.8 per 10,000.
• In 2011, direct payments were most common in the age ranges 18-34 and 65 plus.