Page 18 - TLAP Beyond Direct Payments

Beyond Direct Payments
Unfortunately health and social care funders have tended to treat contracting as only something that can be done through a complex process of competitive tendering where large contracts for support services are offered to organisations. This approach seems to ignore some basic realities:
Consumer rights. Procurement rules makes clear that when people can pick their own support then their right supersedes any obligation to use complex tendering rules (Villeneuve-Smith & Blake, 2016)
Pragmatic reality. People almost always need support quickly and urgently; good support solutions cannot wait on the result of tendering regimes.
Right to terminate. People have the right to terminate their support arrangements. This means that an individual service cannot be treated as ongoing stream to be put out to tender. Only de-personalised approaches can be tendered – and so such tendering should have no place in a personalised system.
Cultural confusion
It is not just a conceptual and contractual confusion around Individual Service Funds
which has created a barrier to their development. Individual Service Funds and the exible contracts they rely on are clearly legal, but they remain counter-cultural. Despite the emergence of the rhetoric of personalisation the thrust of public policy since the 1980s has been towards a managerial approach which assumes that progress is achieved by:
• reducing the level of local control and centralising power
• reducing exibility or discretion and increasing regulation
• reducing divergent forms of support and encouraging standardisation.
Over time a paradoxical situation has emerged in social care: increasingly support is
now contracted out to non-pro t or pro t-making organisations (today local authorities retain only minimal direct control over services). But as services are contracted out so the level of trust between funders and support organisations has reduced.
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