Personalisation and the value of social care

bettys_pictures_407 (2)

Talk given at Social Services Expo and Conference; 19 March 2013

In their report to the Scottish Government, in 2005, Charles Leadbetter (the grand godfather of Personalisation) and Hannah Lownsbrough (of the think-tank Demos) state:

“Good social work is done with people and not for them. That requires: mutual respect and trust; keeping the person at the centre of the work; enabling them to define desired outcomes; and supporting them to develop their own solutions (Leadbetter and Lownsbrough, 2005, p. 4).[1]

However, in 2012, just seven yrs later, the great innovator and protagonist of Personalisation Dr Simon Duffy wrote a formal apology for promoting the idea and system. He states:

“I believe I should make a written apology for two mistakes that are having increasingly negative consequences:

  1. Complex Resource Allocation Systems (RAS) – using questionnaires, points, weightings and formulas to calculate a fair budget
  2. Support Plans – which are now being abused and which are undermining the autonomy of disabled people and families[2]

The roots of personalisation

Some of the roots of “personalisation” are to be found in the disabled people’s movement of the 1960’s and 1970’s. Their origins can therefore be discerned in the emergence of the independent living movement and the articulation of the social model of disability.  Key principles and values of this movement are:

  • Independent living
  • Co-production
  • Participation
  • Control, Choice and empowerment

“Personalisation” also owes its origins, at least in part, to the values and principles of the social work profession.  The philosophy of “putting the individual first”, “respect for the individual”, and “self-determination” have long been at the heart of social work.  BASW [3] states that social work is committed to the five basic values of:

  • Human dignity and worth
  • Social justice
  • Service to humanity
  • Integrity
  • Competence

The Complex RAS

Knowing what your budget is a useful way of enabling you to take more direct control over your own life and your own supports. It promotes autonomy, creativity and a rightful sense of entitlement.

However this does not require a Complex RAS.

Duffy states that the reason that we started to develop a Complex RAS was primarily because senior managers said directly or indirectly “we don’t trust our social workers to make judgements about what is fair and reasonable”.

As Duffy also points out, when people with more power say that they do not trust those with less power, this is never because those with less power are not trustworthy. Rather, it is because of the incompetence of those with more power.

Sceptics of personalisation rightly pointed to the likely problems:

  • The process would disempower social workers and service providers
  • The process would keep breaking – it was too ambitious
  • The process would be used to disguise unfair cuts and cap budgets
  • Local authorities would not show how they did their calculations
  • The process would not empower disabled people and families

Each of which, in some way or other, has happened somewhere in Scotland

One such sceptic is Iain Ferguson, Professor of Social Policy and Social Work at the University of the West of Scotland

He argues that the Personalisation Agenda fails to acknowledge the conflicting agendas involved in current policy debates and, specifically, the extent to which personalisation is also consistent with a neoliberal social and economic agenda which limits, rather than extends, social justice. [4]

He states that personalisation is based on the ‘hybridisation’ of the Independent Living model and neoliberal managerialism within what is now a free market economy within social care.

There is a general failure, Ferguson concludes, within the personalisation agenda to address issues of redistribution (as opposed to issues of recognition) or to locate the experience of people with disabilities within the wider framework of today’s neoliberal capitalism and the effects of the imposition of neoliberal welfare reforms; all of which limit the Agenda’s usefulness as a basis for a progressive social work system.

So, how do we move forward?

Duffy says to make progress social workers and clients alike have to try and do several things at the same time:

  • Avoid solving false problems, problems that are not real but are just symptoms of a flawed system
  • Keep innovating, finding simpler and more respectful solutions to real problems
  • Challenge injustice, don’t accept unfair cuts or damaging policies
  • Build community, share our ideas and be prepared to listen, learn and change

The Independent Living in Scotland Project (which  is part of Inclusion Scotland, an umbrella body of 88 groups of disabled people throughout Scotland) convened a “Pop-Up Think Tank” to discuss Personalisation and Independent Living.  This think tank comprised of representatives from the independent living movement, carers organisations, professionals and academics.

From that think tank it was clear that the goal of professionals and users of social care alike should be that of citizenship and human rights.

However, it was also clear that ‘personalisation’ – a system based on individual allocation of resource, with processes that support that – not only does not deliver this goal, but disempowers both the professional and the user.

It was agreed that a preferred way forward included such things as:

  • Secure a shared vision for a system of social care based on human rights, citizenship and independent living
  • Take advantage of the current integration of Health and Social Care Bill as a significant opportunity to achieve the holistic system desired
  • Develop both a clear set of coproduced entitlements to realise this vision and a funding mechanism that supports such entitlement
  • Support and resource a system of coproduction that ensures power is shared among users, policy makers, front line staff and the local community – this includes supporting DPO’s to engage in this
  • Empower the professional by removing financial considerations from their decisions and supporting common sense based solutions
  • Develop a framework, outlining the route to a system of social care based on citizenship and independent living
  • Set up a commission on the funding of a social care system based on citizenship and human rights to consider at the macro level, decisions on funding needed to underpin this approach

To conclude therefore, I believe that this final point of setting up a commission to look at the value and purpose of social care is vitally important.

As an example, OECD figures for 2009 show the UK only spent 3.7% of its GDP on social services, compared with 7.7% in Sweden; 6.9% in Denmark; and 5% in Norway. Even the tiny country of Iceland spends more on social care than we do, at 4.6%[5]

We – professionals and clients together – do need to stop colluding with successive government, by making do with totally inadequate social care budgets; and in the  process denying disabled people their right to full and  equal participative citizenship.

Together, we need to get back to basics. We need to trust one another; work in co-production; but most of all, together, we need to stand up and ask – what kind of society do we want Scotland to have.  One continuing to be built on the outmoded utilitarianism of the Victorian Poor Law; or one built on equality and active citizenship?

[1] Leadbetter, D. and Lownsbrough, H. (2005) “Personalisation and Participation: The Future of Social Care in Scotland”, London, Demos.

[2] Duffy, S (2012) “An Aapology”, Centre for Welfare Reform, (accessed 14/03/2013)

[3] BASW (British Association of Social Workers) (2002) The code of ethics for social work, Birmingham: BASW

[4] Ferguson  I (2007) “Increasing User Choice or Privatizing Risk? The Antinomies of Personalization”,British Journal of Social Work (2007) 37, 387–403 doi:10.1093/bjsw/bcm016

[5] OECD (2001) “Social Expenditure in OECD countries after the crisis”,  (accessed 14/03/2013)


About jimelderwoodward

Disabled people's rights activist living in Scotland, promoting the principles and practices of independent living, the outcome of which is participative parity as equal citizens in all areas of community life - economic, civic, social and cultural
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