Putting public spending in the hands of the public

One of the things I’ve been looking at a little bit in my temp policy work is the potential for social care services (for older people, people with disabilities and their carers) to be completely reconfigured so that the people who use the services actually get to choose how to spend the funding that is allocated to them. In the UK, this approach is known as self-directed services or personal budgets, and there have been some really interesting trials of how this could work.

This isn’t actually government policy here but I’ve been asked to have an initial look at what the implications of a move in this direction would be for things like regulation, access to services and so on.

It’s a fascinating concept – so simple – you work out how much money gets spent on meeting someone’s needs and you give them control over how to spend this – but so fraught with lots of potential resistance from vested interests, and riddled with all kinds of risks, whether real or imagined. For more, have a look at this report.

When you think about it, paying lots of tax to the state so that it can employ countless bureaucrats to process everything to death, seems like a daft way of doing things. There must be a better way!

One of the reasons this is being thought about in Australia, the UK and other developed countries is the well-known fact that the population is ageing, and that with ageing comes an increased need for care.

A recent report shows that by 2010, there will be an estimated 1.5 million Australians with a “severe or profound core activity limitation”. This is around 6% of the population. As life expectancy increases, so does “expected years of life with disability”. In fact, for women in recent years, 90% of additional life expectancy comprised “extra years with disability”. Hmmm. I’ve always said it will be a little blue pill for me when I hit my eighties!