Caring for People with Learning Difficulties in Scotland: Comparative Costs

Abstract

This paper compares the costs of alternative forms of residential care for people with a learning difficulty in Scotland. The results suggest that whilst it costs less to care for adults with a severe and profound learning difficulty in hospital, it is cheaper to care for adults with a moderate or mild learning difficulty in the community. Evidence of economies of scale was found in providing care for these latter two groups in the community. Foster care placements were the cheapest form of care for children with a severe and profound learning difficulty. Other research has shown that community based small homes provide a superior quality of care.

The British journal of learning disabilities: A history

“…In the same year an article examining the All Wales Strategy referred for the first time to people using services and their families as “consumers” (Todd et al, 1993). The language of business was further appropriated as researchers assessed the value of “quality assurance” in “auditing” services; contracting processes and the need to move from “cost and volume” purchasing arrangements; comparative costs; economies of scale; and joint commissioning in “a diversified mixed economy” (Cambridge & Knapp, 1997; Mansell, 1994; Ryan, 1994; Waddington, 1995; Watson et al, 1993). Discernible In the language of the mid‐1990s is not only the trend towards private sector monetisation of service provision, but also the seeds of firstly direct payments and then the personalisation movement, where the individual claims and then controls and manages the monetary value attached to them.…”