(160) Presentation On Efficiency ( Glasgow, November 2010)

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An exploration of the relationship between efficiency and personalsiation

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  • (160) Presentation On Efficiency ( Glasgow, November 2010)

    1. 1. Efficiency & Welfare Reform Glasgow, November 2010© Simon Duffy. Rights Reserved. The author must be cited if images or slides are used
    2. 2. Whose efficiency in the ‘age’ of austerity• Efficiency is political, not just technical• Power encourages definitions which treat public services as ‘obvious goods’ that need to be delivered at the lowest cost.• Tax payer is promised ‘efficiency’• but ‘mainstream services’ are protected• Negative impact often focuses on the most needy
    3. 3. Personalisation & Social Justice• Personalisation was inspired by visions and values outside mainstream political theory• Provides a capabilities approach that takes us beyond a limited focus on money - real wealth• Provides a non-meritocratic and inclusive vision of social change - equal citizenship• Offers principle of equity - sufficient for citizenship
    4. 4. To achieve citizenship takes real
    5. 5. The goal should be to support
    6. 6. Personalisation is a set ofapproaches for achieving
    7. 7. 3 examples of personalisation • Individual (or personal) budgets • Personalised transition • WomenCentre model
    8. 8. Costs vs Needs (ranked by cost) 70 £60,000 60 £50,000 50 £40,000 40Needs £30,000 30 £20,000 20 £10,000 10 0 £0 1 11 21 31 41 51 61 71 81 91 People Needs Cost
    9. 9. Net Percentage ImprovementHealth & well-being 42% Time with people 52% Quality of life 75% Community life 62% Choice & control 71% Safe & secure 28% Personal dignity 59%Economic well-being 31% 0% 20% 40% 60% 80%
    10. 10. Place Number Change6 Sites Phase I Report 60 -18%17 Sites Phase II Report 128 -9% 13 Sites IBSEN Report 203 -6% Northants 17 -18.7% City of London 10 -30% Worcestershire 73 -17%
    11. 11. 90 Hertfordshire Cambridgeshire Worcestershire67.5 4522.5 0 Person Provider User Trust NB Split budgets are counted against both control mechanisms
    12. 12. Wholly controlled by personSplit with LAWholly controlled by LA 19% 40% 41% Cambridgeshire data on shared usage - total number 63
    13. 13. Explanatory hypotheses Data suggests we can exclude some hypotheses, therefore we can currently assume:• NOT because of lots of professional brokerage - there was very little and where most money was invested in brokerage progress was slowest• NOT because of comprehensive assessments - there were none• NOT because everybody used direct payments or employed their own staff - although c.50% did• NOT because people had to unduly rely upon family and friends - this remained largely unchanged, but was better integrated with paid support
    14. 14. Possible explanatory hypotheses•The ability to integrate paid support more carefully with unpaid support increases efficiency and allows people to focus paid support where it is really required.•The ability to use funding flexibly allows people to identify more creative, individual and appropriate support at the right price•Needs-led approach avoids the definition of need by available service and the inherent upward ratcheting up of costs.•Expensive, crisis-led solutions can be avoided if people are equipped with information early enough to enable meaningful planning
    15. 15. TaxationThe right money... ...to the right person Resource Allocation Targeted System (RAS) Accountability • The right money Wider Market Supported Decision- Making Community • To the right person Family Support Creativity • Maximum choice and flexibility Added Value • Minimum burdens and waste • Clear entitlements Increased Stronger E!ective High Economic Families & Welfare Satisfaction Productivity Communities Reform
    16. 16. • DON’T stop people from knowing their budget or eroding their sense of entitlement• DON’T let your RAS be driven by ‘care planning’• DON’T make planning difficult or obscure• DON’T limit support options for planning• DON’T limit control options• DON’T limit how people can use their moneyIE - We could unintentionally undermine the development of the market either bycreating barriers to entry or weakening the ability of consumers to make theirown choices and shape the market through those choices
    17. 17. Current debates/• Uncertainty about how to manage the RAS• Uncertainty about flexibility and pooling• Failure to utilise providers and ISFs• £0.5 billion wasted on ‘implementation’• The burdening of care management• The failure to look hard at in-house services and block contracts
    18. 18. personalisation will work for people• needing support in the community• managing long-term health conditions• trying to rebuild their mental health• wanting to die at home• wanting more personalised education• trying to find work• wanting to avoid prison
    19. 19. education reform• What is at the heart of learning and personal development?• What are the other 26 pupils paying for?• Schools as social networks for organising learning• Home school networks• Nationalise private education• Rethinking the problem of inclusion
    20. 20. place-based approaches to complexity• As needs become more complex so does the complexity of the response• Service professions, departments, organisational boundaries lead to ‘privileged irresponsibility’• The state struggles to recognise and support civil society responses
    21. 21. this means real poverty is1. Despair - having no hope2. Loneliness - having no friends or family3. Exclusion - never being part of anything4. Disadvantaged - feeling deskilled5. Powerlessness - having no control
    22. 22. success will be dependent upon• ability to spot and support innovation• celebrate and own civil society responses• radically disinvest from current blocks• shifting authority and control to local leadership• new ‘constitutional framework’ with space for innovation
    23. 23. Conclusion: Change?• Resistance is inevitable• Timescales are uncertain• Intentional organisation is required• Success will be a ‘constitutional’ shift in power and control to citizens, families & communities
    24. 24. strategies• smallness provokes less resistance• powerful ideas can create powerful communities• testing and evidence matter• implementation
    25. 25. Contact Details Simon Duffy Centre for Welfare Reform The Quadrant, 99 Parkway Avenue, Parkway Business Park Sheffield, S9 4WG T +44 114 251 1790 M +44 7729 7729 41 admin@centreforwelfarereform.org www.centreforwelfarereform.org
    26. 26. 107.5 Hidden Voices: Hidden Voices: Older People’s Experience of Abuse Older People’s Experience of Abuse An analysis of calls to the Action on Elder Abuse helpline. Written by Action on Elder Abuse and published by Help the Aged 52.5 Help the Aged Action on Elder Abuse 0 Relative Risk Home Sheltered Housing Action on Elder Abuse Data (2004) Hospital Care HomeThe regulation paradox - we regulate thingsbecause they are unsafe, so people believethey have become safe... ... but they are not

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