Why we need the government to act on the Choice Review

With some of our partner organisations, we wrote an open letter last week to Care Minister Norman Lamb MP, urging him to act on the recent Cabinet Office review of choice in public services, which recommended that people should be free to spend personal budgets as they see fit so long as they meet broad outcomes, with the removal of ‘preferred provider lists’ and other traditional commissioning approaches which hamper start-ups, micro-enterprises and other innovators from competing with bigger, more established providers. There’s no point in having control of the money if there’s nothing new or different to buy with it. As reported in Community Care, we warned that without these ‘supply side’ reforms, the risk of personalisation failing in its own terms is high.

A great illustration of the problem is in this Guardian article about how council procurement processes left one social entrepreneur literally starving (at least around lunchtime!) due to their inabiility to renew a contract in a timely fashion. When the basics are so wrong, having an impressive virtual online marketplace for providers and a marketing programme to encourage people to take personal budgets will fall flat.

Our report on Ten ways to stop bashing -and start boosting – micro-enterprise shows how councils can learn from the best work of their peers and get this right, so that we can ‘Make Personalisation Real’, not just another box-ticking exercise.

The illusion of choice

Last year’s Open Public Services White Paper set up free schools and the Payment by Results Work Programme, among other changes. It also proposed establishing a framework for choice in health services, adult social care, early years services, schools and further education. Government departments are drawing up Choice Frameworks, to outline what choice should be available, who is responsible for providing the choice, what quality and inspection measures will be in place and what support people will have to make informed choices and complain if things go wrong.

Since choice became one of New Labour’s mantras, there has been a continuing over-optimism across public service reform about the power of choice alone, to the point where you could be forgiven for thinking that choice is a goal in itself, rather than a way of improving better services.

If you ask people if they want choice in services, they say ‘yes’. but  if you are asked if you want A) a choice of services of varying quality, some of which may be at capacity, or B) no choice but a guarantee that all services are good enough, which option would you go for?

People who see choice as a good thing often have a high level of faith in the power of free markets to self-regulate and to improve to meet consumer demand. They are, therefore, often less keen on the idea of intervening in the marketplace to shape what is on offer: after all, the point is that individual choice will play the role previously played by governments, commissioners, inspectors and all the rest of the traditional service sector.

But the introduction of personal budgets and Direct Payments in social care has shown us