My mind started to wander when I was reading about Integrated Personal Commissioning (which promises to blend health and social care funding for individuals in one pot and allow them, with support, to direct and control how it is used). I find I do that a lot lately, it’s either a sign of ageing or an odd feeling that I’ve been here before, maybe one naturally follows the other.
Back in 1992 I was the Manager of the Gateshead Disability Information Project. We were one of 12 Projects making up the National Disability Information Project, funded by and reporting to the Department of Health (it was still DoH then, before the Health Minister became upset at the comparisons with Homer Simpson). We were firmly grounded in the Social Model of Disability, believing that Disability was compounded by a lack of accessible information. If only Disabled people had an accessible Guide(s) (or these days, a Navigator) to what was out there and how to get it, then their lives would be radically improved.
The problem came once we all looked for what to put in our Directories. We discovered that actually there weren’t many services out there that Disabled people could use. Most were physically inaccessible, couldn’t provide suitable support or were just too expensive. These were the days when most local authorities offered Disabled people a trip to a Day Centre or a place in a sheltered workshop folding cardboard boxes. There was little incentive to provide anything different.
Having tried and learned, we responded by setting up the Gateshead Personal Assistance Pilot Project (I don’t know why we didn’t notice the unfortunate acronym). This was a training and advocacy project supporting Disabled people to set up their own packages of funded care to employ their own Personal Assistants in order to live the lives they wanted to live (using benefits, Independent Living Fund and, when they were introduced in 1997, Direct Payments). In a couple of cases we were able to persuade the NHS to use some arcane regulation that allowed them to make payments to Gateshead Council to produce a joint fund covering both health and social care needs. Where there’s a will ……
It wasn’t all plain sailing, obviously. A manager in Social Services told us firmly he wasn’t going to pay for people to go out and pick daisies and that it wasn’t the job of Social Services to make people happy. It was only later that social services became more relaxed about Disabled people buying football season tickets, going to the pictures, buying and caring for a pet, knitting or making love and having children.
I still have a print copy of our training course, if anyone wants to update it I’m sure I could find it on floppy disc. Whilst I obviously welcome IPC, we could and should all have been doing it for at least the last 20 years.
But anyway, that wasn’t my main point. The unusual thing about the National Disability Information Project in those days was that you could only apply to run a local project if you were a partnership between a local authority, some bit of the NHS and a voluntary organisation. Same as the current IPC process.
Even more unusual, and possibly uniquely, the voluntary organisation was given the whole budget to manage and distribute to the other partners. I had the bank account and the cheque book and the NHS and Gateshead Council had to invoice me to pay for their work.
It had an interesting effect on the power balance, ensuring that we were always involved at the right point in the decision making and that Disabled and Deaf people had real control over what the Project was doing.
So my not so new idea is, why don’t we give the Integrated Personal Commissioning budgets to the voluntary organisation in each local partnership to manage and distribute? We’ve got experience going back over many years, we know how to navigate the systems and we have the trust of the people who matter. Simple.