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Peter Scourfield qualified as a social worker in 1984. Since then, he has worked in various settings, latterly in an Older Person's team. Since 2003, he has worked full time as lecturer at Anglia Ruskin University. His writing and research interests are mainly focused on the adult social care system, with a particular interest in older people's services.Correspondence to: Peter Scourfield, Faculty of Health and Social Care, Anglia Ruskin University, East Road, Cambridge CB1 1PT UK. E-mail: peter.scourfield@anglia.ac.uk AbstractRecent research conducted in the UK for the Commission for Social Care Inspection (CSCI) suggested that there was no evidence to indicate that the involvement of service users and lay assessors in service inspections improved the quality of inspections. However, recently, CSCI has initiated a project to involve 'experts by experience' in their service inspections. Here, the term 'expert by experience' has been adopted to describe users of social care services. However, the appropriateness of this usage has not been without some challenge and various conceptual difficulties have been raised in how the term is used. Reflecting on reports published by CSCI, this paper considers whether the choice of the word 'expert' in this context is really appropriate and also whether, although well intentioned, the involvement of 'experts by experience' is too confused in its rationale to actually empower the people using the services being inspected. The paper concludes by suggesting that the current inspection body-the Care Quality Commission-would do well to review both the terminological and conceptual confusion in respect of this practice.

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Successive governments have encouraged both the marketization and the privatization of the residential and nursing care sector. This paper describes how the large corporate providers continue to increase their share of the market through a continual process of mergers, takeovers and acquisitions. Market analysis suggests that this trend is set to continue. The name given to this phenomenon in this paper is 'caretelization'. The process of caretelization is examined in the context of New Labour's public sector modernization agenda. The paper raises questions of whether continued caretelization is more or less likely to help New Labour achieve certain aims of modernization. For example, New Labour often talks of 'putting people themselves in the driving seat of the public services'. It is argued that, with caretelization, not only is public accountability diminished, but key principles such as consumer choice and user involvement are likely to be compromised by allowing ownership of residential and nursing care to be dictated by market forces. Such developments raise questions about both New Labour's desire and its capability to manage the forces of neo-liberalism.

Direct payments are becoming an important means by which any disabled person can arrange their care in ways that give them more choice and control over how they are supported. A key part of this new freedom is the ability to employ personal assistants (PAs) on terms laid down by the direct payments user. While endorsing the basic principles underpinning direct payments, this article raises questions over whether the employment market in suitably skilled and competent PAs has been sufficiently well researched. For example, with demand set to grow, will there be an adequate supply of reliable workers to employ? It is possible that raised expectations will not be able to be met adequately. The article also raises questions about regulation and training, particularly in relation to how best to ensure that the needs of vulnerable people are met, that risk is managed effectively and that the principle of leaving key decision making with the employer is retained.Issues around direct payments have generated an enormous amount of debate and discussion among disabled people, social workers, carers, politicians, policy makers and academics. The discussion has been joined from a range of different perspectives (Spandler, 2004). Several interrelated themes and overlapping strands to the debate have emerged. Some aspects of the debate appear to be 'settled', while others continue to be contested and problematised. This article will argue that the discussions have been clearer on ends -that is to say, choice, control and independent living -than the means to achieve those ends. The achievement of choice, control and independent living depends, to a great extent, on there being a firm market for personal assistants willing and able to do the necessary work to achieve those ends.To create the context for this article, I will separate out the discussion into two broad strands. The first focuses on the broader political, ideological and policy context. The second is more concerned with examining the various 'ground level' issues of putting policy into practice. The focus of this article falls mainly