Exploring the reality of
Dr Simon Duffy ￭ The Centre for Welfare Reform
￭ 1st October 2013 ￭ Perth, WA
building a better system together
Features of a good system (what to expect,
demand, lobby for or build together).
Examples of self-directed support in
practice (ideas, stories, models).
How to be strong and supportive of each
other (people, families, providers and
• 1990 in London, brokerage, individual funding and service
• 1996 in Glasgow, new models of service provision and Individual
• 1999 in Scotland, working on self-directed support with local
• 2003 in England, led piloting of self-directed support
• 2009, established The Centre for Welfare Reform, global
community for social innovation
• trying to combine practice and theory
Simon Duffy, some background
There is not just one kind of institution
we bring the institution with us
Often English de-instutitionalisation
was institutions without the park
Being a citizen is better than being ‘normal’
it lets us be equal and different
Citizenship for all is practical,
but requires social change
• always improves outcomes
• always increases demand
• sometimes reduces costs
• system design is critical
40 plus years of self-directed support
Rapid policy and large scale
change (700,000 now have
Breakthroughs in flexibility and
awareness of entitlement
System is financially sustainable
Avoided undue reliance on
Development of complex
assessment and RAS, eroding
Support planning industry
Levels of bureaucracy now
Failure to engage providers
System now abused to help
with 33% cut in care
recent changes in England
A system of self-directed support is a system of
funding for support that helps people to achieve full
citizenship. It can have the following qualities:
1.Rights - robust rights that give people effective entitlements
2.Control - person, or someone close to them, controls budget
3.Clarity - systems, rules and budgets are clear
4.Flexibility - budgets can be used in many different ways
5.Ease of Use - it is easy to plan, manage and control assistance
6.Community - person’s contribution to society grows
7.Sustainable - system is affordable, innovative and supported
Can we turn human rights into real
What shouldn’t be cashed out?
Are people’s plans public property?
Is there an alternative to the language of
Is self-directed support a service or an income
adjustment or something else?
Can we do without a RAS?
Why do we want complex assessment
What do we mean by ‘sufficient’ ‘reasonable’
‘necessary’ ? Necessary for what?
Should we means-test love and community?
Can people use their money to buy things
which are not ‘services’?
Can people use their money flexibly and pool it
with their other resources?
Is self-directed support transformational or
What purpose is served by complexity?
Can providers evolve to embrace, support and
underpin self-directed support?
Do we need a new professionals?
What of social workers and other existing
How do you resist the plausible regulation?
can happen at
any levels, but
Innovation is complex, evolving and requires
different strategies at different stages.
How can you ‘design in’ affordability?
How can system change be both liberating and
When change is inevitable how do you frame it
How can you let everyone to join in?
As Western Australia develops
a system of self-directed
support what would I want to
Peer support - providing
information, learning from others
Making sure there is real control and flexibility in
how we deliver services - across whole
organisation. Make the block funding flexible.
An online forum for people, families and providers.
Plus regular face-to-face events (computers don’t
work for everyone)
Engage differently - use
‘entitlement’ - challenge more
People and families
- being part of the dialogue of development
- make an input
Quality audits - show how people’s outcomes is
the best response to ‘quality’
Certificated programmes available
to understand all of your disability
rights, including funding
Work with bell curve - how to
support innovation and the
people who are stuck
Providers use infrastructure to
support peer support
Push for more
a system that is pro-community
inclusion and accessibility
amplify voices for rights:
people & parents
MH and elder
equity in NDIS
the age discriminations
public register for support for
financial advice, planning etc.
construct the entitlement argument
How will I contribute?