Public Policy Editor
Local authorities are to be given powers to provide disabled people with cash rather than care in a change heralded as"risky and scary" but as potentially significant as GP fund-holding.
Legislation to be announced in today's Queen's Speech will allow councils to give the disabled cash with which to buy their own packages of care, rather than providing them with services direct under care in the community.
The idea has widespread backing among organisations for the disabled and may in time be extended to the elderly and the less severely mentally ill.
The change marks a watershed for a system in which - with a few exceptions - the provision of money has been the responsibility of central government through social security since 1948. Local authorities, outside Scotland, have been limited to providing direct services and are debarred by law from providing cash. The chief exceptions have been small grants to help children and families.
Roy Taylor, director of social services for Kingston, an authority which pioneered direct payments to the disabled before discovering that they were unlawful, said it would make "a fantastic difference to people with disabilities, allowing them to become their own care managers. It will give them control of the services they want to buy and all the evidence is that it will provide better value for money".
As a change to the way care in the community is run, it is "as risky and scary but as potentially exciting as GP fund-holding", Denise Platt, director of social services with the Association of Metropolitan Authorities, said.
The move was signalled last year by Virginia Bottomley when Secretary of State for Health, who said the scheme would initially be limited to "a relatively small group, probably those disabled people who are able and willing to manage their care".
Despite the legal bar, a growing number of local authorities have been circumventing the law in recent years by making payments through third parties - providing grants to local voluntary organisations who then make cash grants to individuals.
Most disabled people use the money to buy the time of personal assistants, choosing the hours they want covered and the other services they need. A study undertaken last year by the Policy Studies Institute (PSI) for the British Council of Organisations for Disabled People found that those who handled the cash themselves bought care more cheaply and efficiently than when social services provided the services direct - and reported higher levels of satisfaction. Only 40 per cent said they had unmet needs, against 80 per cent of those receiving allocated services.
Worries that carers could be exploited by those for whom they work - and vice versa - remain, although Mr Taylor said there was sufficient experience now to overcome such problems.
Local authorities will resist any attempt by government to debar the disabled from buying council services with the cash and insisting that the money is spent in the private and voluntary sectors. They are also anxious that the grants should not become a substitute for social security benefits for the disabled.
Local authorities, however, say that talks with the Government on details of the scheme have gone well and that they are in favour of the scheme in principle. The PSI suggested that 90 per cent of local authorities would make direct payments once the law allowed it.