Older people will be given budgets to buy personal care

BMJ 2007; 335 doi: (Published 13 December 2007) Cite this as: BMJ 2007;335:1231
  1. Zosia Kmietowicz
  1. 1London

    A new way of funding social care in England was announced by the government this week. In future, individual budgets will be given directly to older people and people with disabilities so that they can buy their own personal care.

    In what will be seen by many as a monumental shift away from top-down management from Whitehall, Alan Johnson, the secretary of state for health, said, “We want to give people more control over their services in order to increase their quality of life.”

    He announced £520m (€720m; $1100m) of ringfenced money, half of which would come out of the health budget, to support councils to redesign their services to better meet the needs of people who have to buy care.

    He described the concordat Putting People First as “groundbreaking” for being the first time that central government has instigated a major shift in the way public services are delivered together with other agencies, this time including local government, the NHS, service users, and their carers.

    Gordon Brown, the prime minister, said that the creation of individual budgets would lead to “more personal and responsive care.”

    Under the new system, which will take effect from next April, there would be more competition between service providers, which would leave no room “for care homes which do not respect people’s dignity,” said Mr Johnson.

    Councils would also be expected to provide a “one stop shop,” where people needing to buy care, whether it was with their own money or with that given to them through social services, could get advice on the services available locally and what kind of help best suited their needs.

    Ivan Lewis, parliamentary undersecretary of state at the Department of Health, said there would be more emphasis on prevention to help older people stay at home rather than need to go into a care home. Carers would also be treated as “equal partners” in deciding what services were most appropriate for people.

    The government is preparing a green paper on long term reform of social care funds that will include a review of the eligibility criteria for state funding. “There are many local authorities that are spending outside the eligibility criteria, and we now want this to become mainstream,” said Mr Lewis.

    He hoped the new money for reform would help to increase accountabiltiy of local government; increase collaboration between local social services and the NHS; and empower staff.

    Speaking in favour of the change at a press conference to announce the policy, Julia Winter, from Essex, who has myelopathy and brittle asthma, has had control of her social care budget for the past 18 months. She says that choosing her own care has allowed her to decide who comes into her home to help with her care, at a time that is convenient for her. She has also been able to install air conditioning into one room in her house, which she hopes will help to keep her out of hospital.

    Paul Cann, from Help the Aged, said, “The focus on individual budgets and personalisation promises to empower older people and their carers to drive the decisions that shape their lives. This is a huge step forward, which should bring significant benefits for older people.”


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