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Assessing the Role of Increasing Choice in English Social Care Services

Published online by Cambridge University Press:  21 January 2011

MARTIN STEVENS
Affiliation:
Social Care Workforce Research Unit, King's College London email: martin.stevens@kcl.ac.uk
CAROLINE GLENDINNING
Affiliation:
Social Policy Research Unit, University of York
SALLY JACOBS
Affiliation:
Personal Social Services Research Unit, University of Manchester
NICOLA MORAN
Affiliation:
Social Policy Research Unit, University of York
DAVID CHALLIS
Affiliation:
Personal Social Services Research Unit, University of Manchester
JILL MANTHORPE
Affiliation:
Social Care Workforce Research Unit, King's College London email: martin.stevens@kcl.ac.uk
JOSÉ-LUIS FERNANDEZ
Affiliation:
Personal Social Services Research Unit, London School of Economics
KAREN JONES
Affiliation:
Personal Social Services Research Unit, University of Kent
MARTIN KNAPP
Affiliation:
Personal Social Services Research Unit, London School of Economics
ANN NETTEN
Affiliation:
Personal Social Services Research Unit, University of Kent
MARK WILBERFORCE
Affiliation:
Personal Social Services Research Unit, University of Manchester

Abstract

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.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011

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