Neo-Liberal Individualism or Self-Directed Support: Are We All Speaking the Same Language on Modernising Adult Social Care?

Abstract

This article explores recent developments in the modernisation

What Justice, What Autonomy? The Ethical Constraints upon Personalisation

“…We suggest that proper attention to these issues highlights ethical constraints that alter the nature and scope of the personalisation agenda within health and social care services. We thus see our argument as contributing to the existing scholarship that critiques the neoliberal marketisation of public services (e.g., Ferguson 2007Ferguson , 2012Roulstone and …”

“…Here we have in mind two broad areas of concern -first, the concern that implementing 'more (consumer) choice' as a means of promoting autonomy carries risks as well as benefits; and second, the concern that this 2 The characterisation of 'choice and voice' in much of the policy literature is based upon a consumerist motif that either explicitly refers to or implies an atomistic, self-maximising and calculative behaviour on the part of individual services users. This formulation bears little resemblance to more profound, collectively sustained forms of 'choice and voice' that have been envisioned by the campaigners for user autonomy (for example, within the disabled people's movement) in their critique of old-style welfare-state institutions (see Roulstone and Morgan 2009). conception of autonomy is inherently limited in ethically important respects.…”

“…This may result in 'enforced individualism' as a substitute for the 'enforced collectivity' of traditional provision (Lloyd, 2010;Roulstone and Morgan 2009). For example, service users may feel pressured to accept a personal budget if, whether in conversation with service providers or through exposure to the policy literature, they detect an inherent normative presumption in favour of personal budgets and against traditional methods.…”

Disability, Rights and Vulnerability in British Parliamentary Debate

“…Garrett, 2015;Jensen and Tyler, 2015;Roulstone and Morgan, 2009). Policy discourse research can be further divided into studies of specific legislation or policy decisions, such as the Welfare Reform Act (2012) (Jensen and Tyler, 2015) or the closure of Remploy factories (Connor, 2010), and broader trends in policy and practice, such as New Labour's attempts at policy reform (Donoghue, 2013) or Margaret Thatcher's attempt to change the terms of social policy debate to secure political legitimacy and the continuity of her welfare reform projects in future governments (Schmidt, 2002).…”

‘Stuck In The Middle With You’: Towards Enabling Social Work with Disabled People

“…This is noteworthy as there is now much evidence that social policy is contradictory (Roulstone and Morgan, 2009), that at times it makes false assumptions about community (Bornat et al, 1993), and about personal and fiscal capacity to deliver key features of the policy agenda. This is becoming particularly stark in the field of 'adult social care' where Independence, Wellbeing and Choice (DoH, 2005) set the agenda for adult social care changes, but where a major squeeze on spending has led to an unprecedented rolling back of eligibility in many areas, so that the benefits of the policy are likely only to go to those assessed as in 'critical' need in many local authority areas (NCIL, 2006).…”