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Elderly and disabled people would choose how their own budget for personal care was spent and organised under government plans.

Ministers say elderly and disabled people themselves, not social workers, should be able to decide on their care and stay in their own homes.

Government Response: Department of Health

John Reid, health secretary, said: "Individual budgets will put a stop to the revolving door of care and care assistants because they will allow people to purchase the care they want. They will be able to choose their own carer or instead of receiving institutional care opt to go on a holiday that will benefit them, and their families, in other ways.

"Our society is changing, the population is getting older. Advances in health and social care mean that health and well-being are improving, people are living longer and more children with complex and multiple disabilities are now surviving to adulthood.

"Social care should be about helping people maintain their independence, giving them real control over their lives and giving them real choice in the services they use. Services must recognise the changing world, our changing attitudes and our ageing population.

"This Green Paper is the third part of our vision for the delivery of health and social care services in England. It sits alongside the NHS Improvement Plan and Choosing Health, the Public Health White Paper.

"This vision is one of inclusion, where an individual's need for care does not reduce them to total dependency and also makes sure that their carers and staff are empowered to help them shape their own lives."

Stakeholder Response: Age Concern

Gordon Lishman, director general of Age Concern England, said: "Today older people are being offered a Hobson's choice - options in principal but not in practice. Direct payments will not work if there are no services for people to choose from locally.

"Offering older people more control over their own care is a step forward, but chronic under-funding means that the structure of older people's social care needs completely rebuilding. Less is being spent per person on older people than on any other age group.

"More money must be ploughed into the simple services that can make or break an older person's independence - a basic grip rail, a wheelchair ramp or help with shopping.

"It is extremely worrying that under these proposals an older person could hire a care worker who is completely un-checked. The desperately under-resourced Criminal Records Bureau should be given a cash injection so that people have the option to check the safety of care workers for themselves.

"Care is a key issue for older voters and they want to see clear commitments, which meet their real needs now."

Stakeholder Response: Help the Aged

Paul Cann, director of policy, Help the Aged, said: "This Green Paper is the most significant development in adult social care in the past 15 years and offers the opportunity for a radical overhaul of the social care system.

"We welcome the recognition that there must be a greater focus on preventing the decline in well being of older people. However, while we recognise the government’s excellent intentions, it must now confront the issue of ensuring that social care is adequately resourced.

Reduced provision of essential low-level social care, such as home help, has in recent years compromised the quality of many lives, increasing the need for more intensive services at points of crisis. Reversing this decline is paramount to promoting independence in later life.

"Whilst we support the principle of community involvement in supporting those with low level needs, careful consideration must be given to the transition from existing systems.

"Help the Aged looks forward to contributing positively to the debate, and ensuring that a wide range of good-quality care options are available to people, regardless of where they live or how much money they have."

Stakeholder Response: General Social Care Council

Rodney Brooke, Chair, said: "It is really significant that social workers are being highlighted in their new roles as navigators and brokers at the same time as the title of social worker is becoming protected. This is a chance to rejuvenate social work and rebuild public confidence in its important contribution to people’s lives.

"We have a great opportunity over this consultation period to look afresh at what people want from their social worker, to clarify roles and tasks they undertake and what this means in the new world of social care – both for adults and for children’s services. The GSCC will be commissioning work to take this forward. This is the start of a new and exciting era for social work."

Stakeholder Response: Commission for Social Care Inspection

Dame Denise Platt, chair of the Commission for Social Care Inspection, said: "The emphasis on handing control back to individuals is vital. We support the thrust to revitalise the way social care is perceived and delivered. Indeed, many of the ideas came from the work of the Commission with people who use social care.

"Too often people tell us that their services are more accountable to the council than to them. They feel powerless to change what they receive. This cannot be right. Social care services need to change fundamentally in the way they relate to the people who need them.

"This is an important policy statement about how services should develop over the next 15 years and reflects what people who use social care services tell us they want and find important.

"With an election on the horizon, it is important that the ideas in this Green Paper do not get lost. Following the consultation, government will need to act and ensure that the proposals are translated into real policies that make a difference to people’s lives.

"Social care at its best transforms lives, giving independence, choice and control back to people. Policies that support this are to be welcomed."

Stakeholder Response: ARPO50

Donald Steele, director of social policy, said: "Direct payment has been available in other parts of the UK and for disabled groups for several years and this 'catching up' proposal can be given a guarded welcome.

"The principle of dependent elderly people being given some choice in relation to their care provider is a good one but the surrounding uncertainties cast a shadow over the proposal. To begin with there is no guarantee that this will be not yet another 'post-code lottery' with local authorities failing to implement uniform policies throughout the country.

"There is no guarantee that the funds being made available will meet demand and, most importantly, the quality of personal care provided by private agencies is extremely poor in many areas and insistence on proper training for the carers they provide should be part of the package.

"In general the idea of personal control over care must be commended but not if 'staying in your own home' means nothing more than isolation, avoidance of responsibility by local authorities and profit for unscrupulous private care providers."

Stakeholder Response: Carers UK

Imelda Redmond, chief executive of Carers UK, said: "We welcome the recognition given to the role and contribution that carers make to their families and to the community, and the prominence given to carers throughout the Green Paper.

"The Green Paper takes on board many of the issues that have been raised by carers and puts much emphasis on removing barriers within the social care system. Particularly welcome is the focus on equality of opportunity for carers, including the recognition of their right to a life outside caring. Many carers increasingly combine work with care, and it is critical that the right support is put into families to enable them to be economically active for as long as possible.

"The Green Paper makes some welcome recommendations for changing the way social care is delivered, such as personalised budgets, which it is hoped will build on the principles behind direct payments offering individuals greater choice and control over how services are delivered.

"The government acknowledges that demographic changes could lead to a four-fold increase in social care needs by 2050. Carers play an essential role in society, saving the state £57 billion a year - Carers UK’s own research shows that with an aging population the number of carers is likely to increase from 6 to 9 million by 2037.

"At the same time, with a declining working age population, the number of people juggling work and care is likely to increase.

"We hope a full and honest debate can be achieved about the implications of the ageing population, and how this will impact on the delivery of social care and the lives of carers.

"Redesigning goals for how social care should be delivered in the future is only the first step. Carers UK looks forward to participating fully in this debate as friends and family must increasingly be seen as partners in the delivery of social care. The next step must be to look at the future funding of social care in the UK."

Stakeholder Response: Disabilities Rights Commission

A spokesman for the DRC said: "In its contents, the green paper contains the elements for a much needed transformation to a system of social care fit for the 21st century.

"Reform of adult care is crucial in order to ensure that the choice agenda does not pass disabled people by - that the support provided has as its end game the increased participation and belonging of disabled people at all levels – in work, education, leisure and family life.

"Providing real choices to disabled people, though, means tackling the way that risk assessments are being used to deny choice and independence which on a daily basis are trumping disabled people’s ambitions to live independently.

"Delivering the choice agenda to disabled people also means facing up to - and dealing with - the increasing trend of admissions to residential and nursing care.

"For disabled people presently forced to live in institutional care against their wishes, choice is a distant reality. The DRC believes that disabled people should have a right not to be placed in institutional care against their will.

"We need reform that creates real opportunities for disabled people to be active, visible citizens rather than the isolated, excluded and passive recipients of what others deem best."

Stakeholder Response: Leonard Cheshire

John Knight, head of policy at Leonard Cheshire said: "For many disabled people direct payments are simply an aspiration. This is because the tough eligibility criteria for publicly funded social care services ensures that more often than not, only those disabled people deemed as having ‘substantial’ or ‘critical’ needs qualify.

"The charity agrees with the Minister, Stephen Ladyman MP that there needs to be a greater focus on early intervention but that this inevitably will require greater resources.

"Simply tinkering with ‘Fair Access to Care Services’ guidance will not achieve this. Only a radical overhaul will.

"The charity is encouraged by the importance the Green Paper places on giving disabled people real independence, control and greater choice when it comes to choosing and managing the social care services they receive."

Published: Mon, 21 Mar 2005 16:14:50 GMT+00