The downside of individualised social services

This prompts the question: is the promotion of individualised social services just another social dilemma?, as it provides a paradox in its ability to practically provide services. This highlights some of the complexities that are involved when they reform traditionally collective social policies, with their standardised, systematic and rhetorical individualised approach.

Direct payments

Such reform allows the state, in theory, to enjoy the efficiency and budgetary savings that are provided by the market provision of support services to people with disabilities.  In the USA and Europe, the direction for service provision for people with disabilities can vary from country to country, state to state, according to regulations or political economic agendas.  But in general, the system of direct payments allows the person with a disability, or his or her person of choice, to be the employer of personal care services.  This style of reform cuts back on bureaucratic administration.  This, in theory, is believed to give people with disabilities more freedom of choice concerning service provision.

It is of interest to acknowledge that several European countries and the USA have implemented a range of long-term care programs, such as direct payments, which, in theory, are intended to promote independent living options for many years to come.  Many of these programs of support services provide for cash payments to personal carers, including, in certain countries only, family members of the person with a disability, to allow direct payment for appropriate care.

Government budgetary savings on administration costs for the provision of care for people with disabilities have already and will be appreciated by many Western political leaders.  This points out the probability that by cutting out the administration costs and putting the administrative responsibilities into the hands of the users it is said to help provide a form of empowerment to its users, who are people with disabilities.

To me, as a pragmatic disability scholar, this highlights that the system of direct payments could be shown to be much more effective with the use of co-operatives, that is, in a model of direct payments in which service users can choose who their intermediary is; a co-operative of choice.   Consequently, if a group of people wanted to establish a co-operative, and if that co-operative had a value-added approach, it would thrive and be able to support more people with disabilities.

For example co-operatives would undertake a procedure, where public funds that are allocated to pay for support services, those allocated to the management of disabilities, would be paid directly to administer and supply adequate care for people with disabilities.  Those funds would be controlled by the users, rather than by bureaucrats.  This favourably compares with the old style and with the proposed new style of service provision to people with disabilities.  In the old style a co-operative would have a bureaucrat systematically match a person’s disability with the amount of funds that are made available.  But the new style, in theory, provides for a system where a co-operative calls the shots, rather than bureaucrats.

The following example illustrates the argument.  If over the next five years there are 2,000 people with disabilities in need of support through personal care for various reasons related to their disabilities.  Those allocated funds would be pooled and a co-operative would invest them in a way that would be productive and match with the users of direct payments.  As a result, decision making for the process of direct payments would be made through a theoretical collective approach defined by a co-operative of people who the user of direct payments chooses.

This approach to the strategy of the service provision for people with disabilities provides for a win-win partnership, as people with disabilities and their co-operatives could also develop sustainable business relationships with private companies that supply, for example, mobility aids to people with disabilities.  This form of strategic business plan could help with the provision of ongoing support to people with disabilities.  This strategic and creative use of public money is controlled by the users through their co-operatives, giving a form of personal empowerment to people with disabilities.

However, without the objective administration process supplied by the collective allocation of direct payments, in practice this would be a primary target for the misallocation of public funds.  For example, a person with a disability or trustee, is the recipient of $30,000 to supply care needs for the next six months.  Lacking the administrative skills and diligence of the public service, and like most humans, will indulge themselves in a small spending spree, but in this case probably on disability equipment, regardless of the individual’s care needs.  I understand this program entails comprehensive training, but upfront, the long term need for care is superseded by the human temptation to commit economically self-interested actions.

So if bad decisions are made then care time has to be shortened and carers have to share the blame for the poor administration of funds. Because of the misallocation of funds, a carer's time may have to be cut from 4 to 2 ½ hours to compensate the error by the collective's office bearer, even when a personal administrative error is made. It is a social system of shared responsibility.

To give a small example, such an action is a constant occurrence in the Continence Aids Assistance Scheme, where a person with a disability is given $480 a year for the purchase of continence aids, in many cases this is allocated mainly for the purchase of enemas.  In such a situation the purchaser, myself on many occasions, is easily side tracked and spends too much of the given monies on non-essential aids, leaving a shortfall for the purchase of essential items. So what we are also dealing with here is a way of support that also helps regulate direct payments, since regulation also costs money and current governments do not see such support as an investment (as they should) but as a diversion of funds from a budget surplus.

In conclusion, I have briefly outlined some of my criticisms within the disability sector of the largely rhetorical and dominant political ideology known as individualism.   I have subsequently outlined how the flaws of gatekeeping and regulation may be assisted by independently selected co -operatives.