Direct payments: the views of older people from rural communities and ethnic minority groups.

Abstract

The origins of the direct payments scheme lie with the Disabled People’s movement and the revolutionary idea of providing disabled people with cash to pay directly for their assessed care and support needs. Authorisation was given in 1997 to local authorities in England to offer cash payments to purchase care and support services through the implementation of The Community Care 1996 (Direct Payments) Act. This scheme was initially restricted to those aged between the ages of 18-65 years. However since February 2000 (July 2000 in Scotland) this has been extended to include disabled people aged 65 and over, and further expanded in 2001 to include young disabled people between the ages of 16 and 18 years. Prior to the implementation of the Community Care Act, procedures following a community care assessment placed the local authority in complete control regarding arranging and coordinating an individual’s care package. The local authority arranged when and where services were provided, and who would provide them. The direct payments scheme could offer an alternative, more flexible approach, with the potential to empower individuals choosing to opt into this scheme. Individuals in receipt of direct payments have control in making arrangements for the provision of services that work with their lifestyle as opposed to their lifestyle ‘fitting around’ local authority organised care and support services. Direct payments position the individual at the centre of control for their own service provision. Initially, direct payments as a scheme was relaxed and local authorities were not obliged to offer direct payments as an alternative to everyone. However, since April 2003 (June 2003 in Scotland), local authorities are now obliged to offer direct payments to all those eligible. Key criteria for eligibility to opt into this scheme are that direct payments in the form of cash can only be offered to those deemed able to consent and manage the direct payment, either alone or with support