The choice and control agenda which promoted independent living, has given way to a system where profits rather than rights take precedence, says Mike Oliver.
“Let them buy Lamborghinis.”
Of all the recent budget headlines, this was the one that caught my attention because it had a familiar ring to it. Not for the first time MPs were expressing concern about whether the general public could be trusted to spend its own money wisely in respect of any private pension pots that had built up.
Back in the 1970s, parliament debated whether the small blue trike, the only outdoor mobility assistance provided by government, should be replaced by a cash allowance which would benefit all disabled people and not just those able to drive. During the debates, many MPs questioned whether disabled people could be trusted to spend the cash wisely and some even asked what would happen if disabled people ‘squandered the money’ in pubs or the recently opened betting shops.
But common sense won the day and in 1976 the Motability Allowance was introduced. There can be little doubt that the decision to provide cash rather than services has been a success – despite recent attempts by the government to cut back on it and to destabilise Motability as a consequence.
The next time disability policy moved to provide cash instead of services was when a number of disabled people, notably in Hampshire and Derbyshire, were able to escape from residential institutions by persuading their local authorities to provide them with cash to buy in their own support services. This informal arrangement was subsequently given legitimacy by the Direct Payments Act in 1996.
This followed a concerted campaign by the independent living movement (ILM) to promote direct payments as a way of giving disabled people the power to control their own services. It’s fair to say that many professionals doubted the capacity of disabled people to successfully manage this for themselves and that is still proving a barrier to the wider take up of the benefit.
Many on the political left had concerns that this was the first brick out of the wall in the process of dismantling the welfare state. But the ILM was always clear that direct payments were only a means of giving disabled people more choice and control in their lives and not an attack on the welfare state itself.
Despite this support for state-provided welfare, policies have moved beyond attempts to extend the numbers of those using direct payments into a full-blown attempt to replace all health and welfare services by cash through the personalisation agenda and the provision or personal budgets for all health and social care.
Under an ideologically-driven government and betrayed by a number of opportunistic organisations and careerist individuals, the vision of giving disabled people choice and control within a supportive welfare state is being transformed into the nightmare of the free market for all health and welfare services where profit is the only motive.
The late Vic Finkelstein often warned anyone who would listen about the perils of embracing the free market when he asked us to imagine how we would feel if every time we went to a restaurant, we had to employ the waiter to take our order and the chef to cook our meal.
It’s entirely right that we should use whatever mechanisms we can to give people more control over the services the state provides for them, but there’s one thing I know for sure. If we fully embrace the free market in the provision of pensions there won’t be many pensioners buying Lamborghinis.