The Future Challenge for Direct Payments

Since 1997, Local Authorities have had the discretionary power to pay cash directly to disabled adults up to the age of 65 and assessed as needing social service support. More recently, the scope of Direct Payments has been widened to include people aged over 65 years and will, under the Health and Social Care Act 2001, be extended to further groups including disabled people from 16 to 18 years of age and parent carers of young children with impairments. Direct Payments have the potential not only to impact radically upon an individual's quality of life but also to influence the 'community care' market economy and the way personal support services are purchased and delivered in the future. Recent figures from a survey undertaken by the Association of Directors of Social Services suggest that 80% of local authorities have already introduced a Direct Payments scheme and that over 3500 people are already in receipt of direct payments (Jones, 2000). This paper is based upon evidence from a user-controlled Best Value Review of Direct Payments (BVDP) in Wiltshire. It explores, from disabled people's perspective, the advantages and disadvantages of Direct Payments, and demonstrates the challenges still facing both service users and service providers.     

Independence pays: a cost and resource analysis of direct payments in two local authorities

Although there is an increasing amount of literature on direct payments (DP), to date there have been few studies which have examined in any detail the costs and resources associated with them. This paper presents findings from a two year study conducted in two Welsh local authorities that jointly fund an Independent Living Support (ILS) scheme. The main study was not designed to provide definitive cost comparisons with conventional services, however, cost and resource implications of DP were considered and an analysis to determine comparative costs between DP and traditional services was undertaken. The study notes the difficulty in identifying the true cost of DP and reasonable comparators with traditional services. A set of four case studies are presented comparing actual costs of DP and in‐house and independent sector services in the two local authorities studied. The comparison of costs and resources, which did not include significant costs for traditional local authority services but included the cost of the DP support scheme, found that DP was cheaper than traditional in‐house service provision and relatively cost neutral when compared with independent sector provision. User satisfaction, however, was significantly greater with DP than traditional service delivery methods. The paper also examines factors which can potentially influence the cost of DP. The study suggests that DP represent a substantial improvement over traditional arrangements from a cost–benefit perspective. There is strong evidence to suggest that greater ‘opportunity cost’ savings can be anticipated when DP schemes become more fully integrated into policy, practice and procedures.     

Direct What? The Untapped Potential of Direct Payments to Mental Health Service Users

This article describes research carried out for the Central Research Unit of the Scottish Executive about Direct Payments to mental health service users including people with dementia. Previous research had found that Direct Payments were not often, if at all, offered to mental health service users. Using focus groups, interviews and a telephone survey, Scottish Health Feedback explored the extent of implementation of Direct Payments across Scotland, and the views of mental health service users, carers and professionals about the idea of Direct Payments, the potential obstacles, and the support that would be needed. Awareness of Direct Payments was low, even among professionals. Many were hearing about this option for the first time through this research and a common reaction to the research questions was 'Direct what?' The study found that in order to make Direct Payments work for mental health service users, what was needed was 'person-centred' assessment, access to proper support, advice and training, and Direct Payment schemes that were flexible to allow for different arrangements and for transitions.     

Personal assistance at work: the Visual Assistance Service in Taiwan

'Personal assistance' is a key to equal and full participation by disabled people in society. In Taiwan, there are services provided to 'care for' disabled people, but not to support them at work. In view of this, a pilot scheme called the 'Visual Assistant Service' was developed in 2003. This study explores how the visually impaired users, project workers and Visual Assistants viewed the service. The findings show that this service has improved visually impaired workers' sense of control at work and reduced their enforced dependence on their informal support networks. However, users had little control over the way the services were provided. This reveals a lack of full understanding by professionals with regard to the western ideas of 'personal assistance' and the independent living movement.     

The potential for collaborative agri-environment schemes in England: Can a well-designed collaborative approach address farmers’ concerns with current schemes?

There is increasing recognition that whilst agri-environment schemes in England have had discernable benefits, their success in relation to certain species and resources has been inhibited by the piecemeal implementation of Environmental Stewardship (ES) on the basis of single farm agreements. In this paper we examine the receptivity of farmers to the idea of landscape-scale, collaborative agri-environment schemes (cAES) based on semi-structured interviewing in three English case-study areas. Using qualitative sociocultural interpretation we argue that a lack of communication and mutual understanding between farmers; a cultural imperative for independence and timeliness, and; alternative interpretations of risk amongst farmers present potential barriers to cAES. We also argue, however, that if designed appropriately, cAES have the potential to overcome certain concerns that farmers hold about the existing ES schemes. In particular, cAES are likely to gain support from farmers where they are seen to offer greater flexibility; scope for farmer involvement in scheme design; locally targeted and clearly defined aims, and; demonstrable benefits that can be monitored as a record of success. We provide policy recommendations and suggest that cAES have the potential to deliver greater environmental benefits, whilst at the same time encouraging farmers’ participation in, and satisfaction with, agri-environment schemes.     

The personalisation agenda: the case of the Australian National Disability Insurance Scheme

As part of the international trend towards personalisation, in 2013 Australia launched a major disability scheme aiming to give participants greater choice and control over services. The scheme aims to cover a wide diversity of disabilities, services and significant geographical area – resulting in a highly complex system of local overlapping markets. At four years into implementation a range of challenges have emerged. In this paper we firstly describe the Australian National Disability Insurance Scheme, then explore a range of implementation challenges it currently faces as a large-scale personalisation scheme. Based on these experiences we pose a range of questions for similar schemes internationally.     

‘It was clear from the start that [SDS] was about a cost cutting agenda.’ Exploring disabled people’s early experiences of the introduction of Self-Directed Support in Scotland

Abstract

The adoption of personalisation represents a global paradigm shift in the organisation of social care. However, such approaches have been criticised for failing to bring about transformative change. The passage of the Self-Directed Support (Scotland) Act (2013) was intended to bring about a significant change in the organisation of social care in Scotland, giving increased choice and control to new user groups. The implementation of the policy at a time of significant financial constraint for local government has cast doubt on this potential. This paper presents findings reflecting disabled peoples’ lived experience of this change during the early stages of implementation. Drawing on one-to-one qualitative interviews with disabled people living across the central belt of Scotland, this early snapshot suggests that the policy had not significantly increased choice and control for service users, and that austerity was leading to an erosion of gains made by existing Direct Payments users.     

‘Imposed unknowns’: a qualitative study into the impact of Independent Living Fund closure on users

The Independent Living Fund (ILF) was a non-departmental public body funded by the Department for Work and Pensions. An efficient and popular system of support, the ILF enabled 46,000 people between 1988 and 2015; however, in 2015 the Fund closed and local authorities (LAs) assumed sole responsibility for supporting former ILF users. This article presents the experiences of 12 former ILF users as they transition from ILF to LA support. We focus on participants’ experiences of ILF and LA support, their transition from ILF to LA support, and the emotional impact of transition. Participants were universally positive about their dealings with the ILF, whilst nearly all were worried about LA provision. For most participants, the process of transfer was not smooth; participants received insufficient information and poor communication from LAs. Participants expressed anxiety and uncertainty over the future and these feelings were exacerbated by the actions of LAs during transfer.     

THE NEW FRONTIER: WEB-BASED EDUCATION IN US CULTURE

The USA has always prided itself on the defence of freedom for all its peoples, democracy as well as being on the leading edge of innovations. The USA, therefore, is a particularly unique setting for an examination of the rhetoric associated with the politics of adopting online learning technologies. This paper examines the context of the US on-line learning system with a particular focus on those aspects of the movement which appeal so keenly to Americans. Certain values are expressed in this movement which are almost uniquely American such as democracy, freedom, efficiency, independence, the vocational nature of education, and meritocratic schemes for education as a sorting mechanism for the society.     

The Impact of Economic Freedom and Personal Freedom on Net In-Migration in the U.S.: A State-Level Empirical Analysis, 2000 to 2010

Arguably, private enterprise flourishes under conditions of increased freedom. However, increases in economic freedom can sometimes impose costs on others (negative externalities and monopoly power being prominent examples). Nevertheless, on balance, it is typically expected that the greater the degree of economic freedom, the more successfully and efficiently markets perform and the greater the prosperity created through private enterprise. These net outcomes from greater freedom accelerate economic growth and development, which in turn creates opportunities for yet further success. From a different perspective, it can be argued that greater personal freedom promotes higher levels of utility for consumers in non-economic ways. Accordingly, the present study empirically investigates whether the prospects of greater economic freedom and/or greater personal freedom in any given state vis-à-vis other states act(s) to induce a greater net influx of migrants. This empirical study of internal U.S. migration over the study period from 2000 to 2010 finds clear evidence that migrants prefer to move to those states with greater economic freedom on the one hand and greater personal freedom on the other hand.     

THE SOCIAL GEOGRAPHY OF GENDER-SWITCHING IN VIRTUAL ENVIRONMENTS ON THE INTERNET

The virtual social worlds of the internet give people unparalleled control over the construction and presentation of their identities. Gender-switching is perhaps the most dramatic example of how people exercise this control. It occurs when people present a gender that is different from their biological sex. While gender-switching figures prominently in academic commentaries and popular writings about on-line social life, there is little systematic research on the phenomenon. On-line surveys of two stratified random samples (N's=233 and 202) of MOO users were conducted. The majority of participants (60 per cent) in social MOOs (popular text-based internet social venues) had never engaged in gender-switching, while the majority in role-playing MOOs were either gender-switching currently (40 per cent) or had done so in the past (16.7 per cent). More than half of those who currently gender-switched did so for less than 10 per cent of their time on-line. In spite of the freedom to use indeterminate or even plural gender identities, most participants who switched genders (78.7 per cent) did so within traditional binary conventions (male to female, female to male). The primary reason for gender-switching was the desire to play roles of people different from one's self. The primary barrier to gender-switching was the belief that it is dishonest and manipulative. Attitudes toward gender-switching and on-line participation were better predictors of gender-switching than personal background demographics or personality measures. The images of gender-switching that emerge from this first systematic study of the phenomenon are considerably more benign than that usually portrayed in the literature. Gender-switching appears to be practised by a minority of MOO users for a small percentage of their time on-line. Gender-switching within MOOs of all kinds might best be understood as an experimental behaviour rather than as an enduring expression of sexuality, personality, or gender politics.     

From Adolescence to Young Adulthood: the partnership challenge for learning disability services in England

The transition from adolescence to young adulthood is acknowledged to be difficult for all young people, but the problems facing those with a learning disability will tend to be greater. This article identifies these additional difficulties, and considers the extent to which new policy requirements and expectations in England can address them. At the heart of this new approach is the need for partnership working between a complex range of agencies and professionals. What is at stake is not only a better system of support for some vulnerable young people, but also—in microcosm—the viability of partnership working as a policy tool for addressing complex issues.     

Pick-Your-Own Labor: Migrant Workers and Flexibility in Canadian Agriculture1

This paper explores the structures and practices of temporary migrant worker programs (TMWP) as they operate in Canadian agriculture. Acting within highly competitive, globalized markets, agri-food employers rely on the availability of migrant workers to achieve greater flexibility in their labor arrangements, drawing on employment practices beyond those possible with a domestic workforce. Most recently, changes to Canada’s two TMWP schemes have provided employers with greater scope to shape the social composition of their workforce. The paper analyzes these changes while exploring their implications for workplace regimes in agriculture.     

Keeping the cash under control: what's the problem with direct payments in Scotland?

Implementation of the 1996 Community Care (Direct Payments) Act from April 1997 has gradually gained momentum as more and more local authorities have begun to embrace the idea, and develop their own direct payment policies and support structures. However, whilst users have overwhelmingly welcomed this transition, there remains a stark divide between the implementation and promotion of policy in different parts of the UK. This has resulted in only marginal use of direct payments for a small number of disabled persons in Scotland. As legislation moves to widen access to direct payments in Scotland, this article draws on a series of interviews with policy makers in two local authorities and examines some of the key problems that, to date, have prevented many authorities from offering direct payments as a mainstream service option for disabled people.     

An exploration of older Hong Kong residents’ willingness to make copayments toward vouchers for community care

Because of its rapidly aging population, Hong Kong faces great challenges in the provision and financing of long-term care (LTC) and needs to explore sustainable funding mechanisms. However, there is a paucity of research on older people’s willingness to pay (WTP) for LTC services in Hong Kong. This study utilizes data collected in Hong Kong in 2011 (N = 536) to investigate older people’s receptivity to this financing mode by assessing their co-payments for a community care service voucher scheme and then testing how potential factors affect respondents’ amount of co-payment. Results show that respondents’ WTP was positively associated with family financial support, financial condition, and positive attitudes toward this novel policy and negatively associated with family caregiving support. Direct and moderating effects of family financial support on WTP were found. The policy-related implications of LTC financing to improve older people’s acceptance of co-payment mechanisms, financial condition, and shared responsibility of care are discussed.     

2014 Presidential Address to the MSSA Membership: Academic Freedom,Free Speech and the MSSA Community of Scholars

This article includes the text from my Presidential Address given at the annual banquet of the Mid-South Sociological Association in November of 2014. In the speech, I highlight the challenges to academic freedom, the importance of a right to free speech, and the responsibility that comes with having both. I further argue that the MSSA, as an association of professionals, draws on the camaraderie it fosters in our organization to support and aid those who fight against the threats to academic freedom.     

Strategy-proof Cardinal Decision Schemes

This paper analyses strategy-proof mechanisms or decision schemes which map profiles of cardinal utility functions to lotteries over a finite set of outcomes. We provide a new proof of Hylland’s theorem which shows that the only strategy-proof cardinal decision scheme satisfying a weak unanimity property is the random dictatorship. Our proof technique assumes a framework where individuals can discern utility differences only if the difference is at least some fixed number which we call the grid size. We also prove a limit random dictatorship result which shows that any sequence of strategy-proof and unanimous decision schemes defined on a sequence of decreasing grid sizes approaching zero must converge to a random dictatorship. We are most grateful to an Associate Editor and two referees for very helpful comments on an earlier version of the paper. An erratum to this article can be found at     

Perceived Freedom and its Sociological Effects: An Inquiry into the Relationship Between Liberalism and Inequality

Abstract:  Individual freedom has been regarded as one of the most important criteria for a desirable society and life. Recently, the theories of liberalism and distributive justice have received increasing attention as a theoretical basis for tackling problems pertaining to socioeconomic inequality and poverty. However, few quantitative analyses focus on the meaning of freedom in the context of socioeconomic inequality and political order in an existing liberal-democratic society. In this paper, I construct a self-rated measure of freedom—the overall perceived freedom scale—and examine (1) whether socioeconomic inequality is related to inequality of freedom, (2) whether freedom is related to subjective well-being, and (3) whether freedom affects people's political attitude toward inequalities. Analyses using data from a 2005 Japanese national survey ( N  = 1320) reveal the following results: (1) people with higher personal income (not household income), higher education, and better health tend to perceive greater freedom, (2) people with higher perceived freedom are more likely to be satisfied with their life, and (3) individuals with higher perceived freedom are more likely to oppose the government's egalitarian policy, and their opposition is based on the liberal principle of freedom and self-responsibility. On the basis of these findings, the double-edged possibility of individual freedom and liberalism as an "enhancer" and "moderator" of socioeconomic inequalities and political conflicts is suggested.     

Datafying anti-poverty programmes: implications for data justice

ABSTRACT

This paper seeks to illuminate the significance of datafication for anti-poverty programmes, meaning social protection schemes designed specifically for poor people. The conversion of beneficiary populations into machine-readable data enables two core functions of social protection, those of recognising entitled beneficiaries and assigning entitlements connected to each anti-poverty scheme. Drawing on the incorporation of Aadhaar, India’s biometric population database, in the national agenda for social protection, we unpack a techno-rational perspective that crafts datafication as a means to enhance the effectiveness of anti-poverty schemes. Nevertheless, narratives collected in the field show multiple forms of data injustice on recipients, underpinned by Aadhaar’s functionality for a shift of the social protection agenda from in-kind subsidies to cash transfers. Based on such narratives the paper introduces a politically embedded view of data, framing datafication as a transformative force that contributes to reforming existing anti-poverty schemes.