Personalised Transition from Personalised Transition by Alison Cowen
I want patients to have far more control over the care they get. So people with long termconditions get to be part of designing the care they need. Choosing what suits them -and making it work. For mental health patients. For pensioners in need of care. Forpeople with disabilities. It works.A couple of weeks ago in Shefﬁeld, I met a wonderful woman called Katrina. Shes gotthree disabled sons. The oldest is Jonathan, a charming, warm hearted young man of 19.He cant walk or talk clearly, or feed himself alone. Hes had a breathing tube in his necksince he was a toddler. Under a scheme the new Liberal Democrat council in Shefﬁeld isextending, Jonathans just got his own individual budget and care plan.Now hes doing work with a local charity, attending a music group, has his own personalassistant. A child whose potential seemed so limited. Finally as a young man, engaged inlife in a way he and his mother never thought possible. Katrina told me with the biggestsmile Ive ever seen. She said: Weve gone from having nothing to having everything. Iwish every childs needs would be taken this seriously.(Nick Clegg, 17 September 2008).
• Virtual budgets predominate• Individual budgets bureaucratised• Commissioners limit choice and market development• Advocacy and legal aid slashed
Local government will face (excluding police andﬁre) a cut in funding of 28% from 28.5 to 22.9billion - in real terms. However approximately 20billion of local government are social care services(children and adults). So in order to deliver thesecuts local government will be forced to:• Cut £5.6 billion from social care• Reduce eligibility - 250,000 people will lose vital supports• Cut staff - 250,000 people will lose their jobs• Cut the salaries of the some of the lowest paid workers
Beneﬁts cuts will include:• a change in indexation of uprating beneﬁts from the higher Retail Price Index (RPI) or Rossi to the lower Consumer Price Index (CPI), said to save £6 billion a year by 2015• the reassessment of claimants of Disability Living Allowance (DLA) to drive a 20 per cent reduction in costs [c. £2.4 billion]• and the reassessment of Incapacity Beneﬁt (IB) claimants to move more onto JSA – a plan ﬁrst proposed by the previous government and intended to save £1.5 billion, and which the current government believes will see 23 per cent of IB claimants moved to JSA
The multiple beneﬁt reforms and the creation of asystem of Universal Credit mean the ﬁnal impact isuncertain in many areas. However government strategyhas been:• protect and strengthen pensions• invest more in back to work programmes to reduce the tax burden on those on the verge of work• to reduce the overall cost of beneﬁtsThe only way of squaring this circle is to reducespending on disabled people, families and carers.
Beneﬁt (£ billions) 10/11 (mn) pc paRetirement Pension 72.392 protected 12.537 £5,774Tax Credits 24 protected 7.2 £3,333Housing Beneﬁt 21.519 vulnerable 4.75 £4,530Disability Living Allowance 12.467 vulnerable 3.214 £3,879Attendance Allowance 5.436 vulnerable 1.635 £3,325Child Beneﬁt 11 questionabl 7.2 £1,528 eIncome Support 5.763 vulnerable 1.746 £3,301Pension Credit 7.673 vulnerable 2.664 £2,880Council tax beneﬁts 4.085 vulnerable 5.794 £705Jobseeker’s Allowance 4.841 questionabl 1.402 £3,453 eCarer’s Allowance 1 vulnerable 0.566 £1,767Employment Support 6.869 questionabl 2.469 £2,782 eAllowance + IBIndependent Living Fund 0.2 terminated 0.021 £9,524TOTAL 177.245 2010-11 Figures from DWP for major beneﬁts - child beneﬁt and tax credits from other sources
This is a pincer attack on the rights of disabledpeople. If we just focus on the 1 million people withthe most signiﬁcant disabilities - they will lose:• £5.6 billion in social care support• £0.7 billion in disability living allowance• Termination of ILF• Cuts to Supporting People• Many further cuts in housing support and other beneﬁtsSo, more than £7 billion of the total £27 billion(>25%) which government is saving fromdepartmental budgets is being born by less than 2%of the population - those who are least able to bear
• People with mental health problems• Women suffering domestic violence• People out of work• Refugees and asylum seekers
Everyone is equal, no matter their differences ordisabilities. A fair society sees each of its members as afull citizen - a unique person with a life of their own. Afair society is organised to support everyone to live afull life, with meaning and respect.• Family - we give families the support they need to look after each other.• Citizenship - we are all of equal value and all have unique and positive contributions to make.• Community - we root support and services in local communities.• Control - we have the help we need to be in control of our own life and support.• Capacity - we are helped to be the best that we can be.
• Weak entitlements - eligibility thresholds high and rising, legal rights weak• Super-taxation for disabled people - means-testing, charging• Poverty traps - beneﬁt systems that punish families, savers and earners• Weakened families - support focused on crises,family control undermined, families disrespected• Imprisonment for many - up to 20,000 people with learning difficulties in prison
1. Integrate tax and beneﬁts - remove stigma and complexity2. Take means-testing out of beneﬁts - we’ve already paid our taxes3. Deﬁne minimum level of eligibility for all - transparently deﬁne a level sufficient for citizenship4. Constitutional rights to support and control - clear law that can be tested and protected5. Fix a robust organisational framework - escape the era of ‘organisational ﬁxes’
From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde