Assessing the role of increasing choice in English social care services

TY - JOUR

T1 - Assessing the role of increasing choice in English social care services

AU - Stevens, M

AU - Glendinning, C

AU - Jacobs, S

AU - Moran, N

AU - Challis, D

AU - Manthorpe, J

AU - Fernez, J L

AU - Jones, K

AU - Knapp, M

AU - Netten, A

AU - Wilberforce, M

PY - 2011/1/21

Y1 - 2011/1/21

N2 - This article aims to explore the concept of choice in public service policy in England, illustrated through findings of the Individual Budgets (IB) evaluation. The evaluation tested the impact of IBs as a mechanism to increase choice of access to and commissioning of social care services around the individual through a randomised trial and explored the experiences and perspectives of key groups through a large set of interviews. The article presents a re-examination of these interview data, using three 'antagonisms of choice' proposed in the literature - choice and power relations, choice and equity, and choice and the public nature of decisions - as organising themes. The randomised trial found that IB holders perceived they had more control over their lives and appreciated the extra choice over use of services, albeit with variations by user group. However, problems of power relations, equity and the constraints implied by the public nature of decision-making were complicating and limiting factors in producing the benefits envisaged. The focus on choice in policy, especially as implemented by IBs, emphasises an individualistic approach. The findings suggest that addressing broader issues relating to power, equity and an understanding of the public nature of choice will be of value in realising more of the benefits of the policy.

AB - This article aims to explore the concept of choice in public service policy in England, illustrated through findings of the Individual Budgets (IB) evaluation. The evaluation tested the impact of IBs as a mechanism to increase choice of access to and commissioning of social care services around the individual through a randomised trial and explored the experiences and perspectives of key groups through a large set of interviews. The article presents a re-examination of these interview data, using three 'antagonisms of choice' proposed in the literature - choice and power relations, choice and equity, and choice and the public nature of decisions - as organising themes. The randomised trial found that IB holders perceived they had more control over their lives and appreciated the extra choice over use of services, albeit with variations by user group. However, problems of power relations, equity and the constraints implied by the public nature of decision-making were complicating and limiting factors in producing the benefits envisaged. The focus on choice in policy, especially as implemented by IBs, emphasises an individualistic approach. The findings suggest that addressing broader issues relating to power, equity and an understanding of the public nature of choice will be of value in realising more of the benefits of the policy.

KW - social care services issues

KW - ill/disabled adults

KW - carers

KW - employment/benefits

UR - http://www.scopus.com/inward/record.url?scp=78651522989&partnerID=8YFLogxK

U2 - 10.1017/S004727941000111X

DO - 10.1017/S004727941000111X

M3 - Article

SN - 1469-7823

VL - 40

SP - 257

EP - 274

JO - Journal of Social Policy

JF - Journal of Social Policy

IS - 2

ER -