People using social care and other local authority services should be given individual budgets so that they can buy in the services they need, according to proposals to radically reform social care, announced by UK Health Secretary John Reid today.

At current levels this would mean £14 billion would be available to 1.7 million people to buy services such as respite care, carers of their choice and new technology to assist in independent living.

Independence, Well-being and Choice: our vision for the future of social care for adults in England sets out government proposals to support choice and promote independence for the increasing numbers of people who will access social care in the future.

Health Secretary John Reid said:

“Individual budgets will put a stop to the revolving door of care and care assistants because they will allow people to purchase the care they want. They will be able to choose their own carer or instead of receiving institutional care opt to go on a holiday that will benefit them, and their families, in other ways.

“Our society is changing, the population is getting older. Advances in health and social care mean that health and well-being are improving, people are living longer and more children with complex and multiple disabilities are now surviving to adulthood. Social care should be about helping people maintain their independence, giving them real control over their lives and giving them real choice in the services they use. Services must recognise the changing world, our changing attitudes and our ageing population.

“This Green Paper is the third part of our vision for the delivery of health and social care services in England. It sits alongside the NHS Improvement Plan and Choosing Health, the Public Health White Paper. This vision is one of inclusion, where an individual’s need for care does not reduce them to total dependency and also makes sure that their carers and staff are empowered to help them shape their own lives.”

Jan Roast, from Oxfordshire, tried for years to find appropriate care for her daughter Gemma. Gemma now receives a package of care supported by direct payments which allows her to live independently with her friend Katy. Jan, who now works for Paradigm, a national consultancy organisation in the field of learning difficulties, and whose role involves working with families in different parts of the country to look at how life could be different for their sons and daughters said:

“I believe the difference in Gemma and Katy’s lives is that it really is their own home. We have designed the service around them, based on their chosen lives and needs, not fitted them into an already existing situation or filled two empty beds! It has been about shifting the emphasis from control by professionals to partnership with families and taking responsibility together to make sure it continues to reflect their choices.”

Caroline Tomlinson from Wigan manages a local voluntary organisation Wigan and Leigh Scope which works with local disabled people and their families. She struggled for years to get appropriate care for her son Joe.

She said:

“We struggled because Joe didn’t seem to ‘fit in’ to the service system. In the first instance he didn’t get a true assessment of his needs and secondly there wasn’t local provision to meet his needs. Joe was fortunate to be part of a national pilot programme called ‘In Control’. This has enabled us to have in the first instance an assessment of need, then we are given a resource allocation, a direct payment, which basically tells us how much money Joe is able to spend throughout the year, we have then been able to develop a plan which says how we as a family want the money to be spent.” Key recommendations of the Green Paper include:

— individual budgets. Care brokers would help people assess their needs, manage their own budget and could act as care navigators

— the development of new responsive models of care including extracare housing and telecare

— strengthening arrangements for greater co-operation and collaboration between the NHS and voluntary and community sector

— new directors of adult social services will provide strategic leadership not just in social care but across all adult services

— greater streamlining of assessments between agencies including local authorities and across government

— engaging the whole of local government to make sure all services are accessible for those with the greatest need and encourage a shift to more preventative services

Stephen Ladyman, Community Minister at the Department of Health, said:

“People’s expectations of social care are low. People have been confronted with services which are complex to access, which don’t deliver the care they want and which take away an individual’s right to make a decision about their life. In a society that values and promotes independence, people who use care services have often been ignored. This is simply the way services have developed over the years but it cannot continue. More people will be using social care in the future. We must look at the way services are delivered.

“This Green Paper sets out our vision. This vision includes individual budgets and extra care housing. It looks at how we involve carers and the voluntary sector more in the provision of care. It includes how we get health and social care to work better together and how we take advantage of technology.

“Make no mistake, services will be driven by the users of those services, not the managers. Individuals will be enabled to make choices. And the services provided will be person-centred, proactive and seamless.

“The outcomes will be improvements in health and quality of life, giving people the opportunity to make a positive contribution and to exercise choice and control, freedom from discrimination and harassment, economic wellbeing and personal dignity.”

Jo Williams – Chief Executive – Mencap, said:

“The vision and principles in the Green Paper are very exciting. They concern the most excluded people in society and from our point of view people with profound learning disabilities often feel marginalised. We will want to see how the proposals translate into action.

“I recognise that this is a 10-15 year strategy and we will need to identify along the way how successful we are in achieving the vision that is set out.”

Tony Hunter, President, Association of Directors of Social Services said:

“We welcome the Green Paper because the principles underlying it are fundamental to all social care services, and were echoed in the joint ADSS-LGA statement ‘All Our Tomorrows’. ADSS believes that if the Green Paper is translated into the outcomes envisaged this will enhance the dignity and well-being of many thousands of people. We welcome also the modernising agenda and the strengthening of local partnerships to create the right environment for change.”

Imelda Redmond, Chief Executive, Carers UK said:

“We welcome the importance in the Green Paper of the role and contribution that carers make to their families and to the community.

Particularly pleasing is the focus on equality of opportunity for carers, including the recognition of their right to a life outside caring. Many carers increasingly combine work with care, and it is critical that the right support is put into families to enable them to be economically active for as long as possible.”

Lynne Berry, Chief Executive, General Social Care Council, said:

“I am very pleased at the focus in the Green Paper on the continued importance of social workers. The proposed new roles of broker and navigator also offer some exciting possibilities. I look forward to engaging in the debate around the training and support that social care staff need to work in these new and imaginative ways.”

Paul Cann, Director of Policy, Help The Aged, said:

“We welcome the drive of policy, heralded by the Green Paper, to give people independence, greater choice and control in meeting their needs for care. We must break out of the cycle of responding, too late and expensively, to people’s needs and to do this the cut in low level services must be reversed. Help the Aged will contribute positively to the debate about ensuring that a whole range of good-quality care is available to people, regardless of where they live or how much money they have.”

David Behan, Chief Inspector, Commission for Social Care Inspection, said:

“The Commission for Social Care Inspection warmly welcomes the themes set out in this important Green Paper. We share the belief that putting people at the centre of everything we do is key to improving the lives of adults who use services.

“Social care services are vital for many hundreds of thousands of adults. It is essential that those services enhance the opportunities and quality of life of those who use them, promoting fuller and more satisfying lives, rather than encouraging dependency and loss of autonomy.

“Whilst we recognise that the arrangements for regulation and inspection are going to change in the future, we continue to have an important role to play in helping to modernise the way social care is delivered and we will be working with the Government and many other stakeholders to play our part in taking forward this new vision.”

Notes to Editors:

Copies of the Green Paper Independence, Well-being and Choice: a vision for adult social care in England are available on the Department of Health website: dh.gov.uk/socialcare. An easy read version will be available, as well as an audio cassette of the easy read version, and the executive summary in braille and several other languages.

The consultation period will end on 28 July 2005.

For further information, media enquiries only, please contact Brenda Irons-Roberts or Orla Delargy, Department of Health media centre, on 020 7210 5231/5315.

GNNREF: 113080
Issued by : DOH Press Office (UK)