Paying the Piper and Calling the Tune: Power and the Direct Payment Relationship

Leece, Janet

doi:10.1093/bjsw/bcn085

Cited by 35 publications

(30 citation statements)

References 10 publications

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“…Individualised budgets allow customers input into the planning of services to ensure tailored outcomes-focused provision; and give the ability to alter everyday routine practices and the organisational culture of providers (Rabiee, Moran and Glendenning, 2009). Moreover, they allow users the ability to choose and exit providers (Leece, 2010).…”

Section: Personalisation Austerity and The Voluntary Sectormentioning

confidence: 99%

Personalisation, austerity and the HR function in the UK voluntary sector

Cunningham

2016

The International Journal of Human Resource Management

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Using the customer orientated bureaucracy (COB) construct, this qualitative study investigates changes to the Human Resource (HR) function's status in eight Scottish voluntary organisations delivering public services at a time of contradictory government calls for greater customer service (personalisation) and cost control (austerity). HR attempts to build and sustain social orders that encourage worker commitment to customer service, leading to business facing and 'business partner' strategic roles in areas of recruitment and skills. The study, however, challenges the ability of unitarist 'business partner' HR roles to resolve emerging organisational tensions concerning industrial relations, worker concerns over their own security, lack of opportunities to up-skill and service quality. It further questions whether the HR function can be strategic in this and other COB contexts as it can be powerless to resolve workplace tensions because its own status is undermined by budget cuts by government and it faces challenges to its expertise from internal and external actors such as consultants and customers.

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Section: Personalisation Austerity and The Voluntary Sectormentioning

confidence: 99%

Personalisation, austerity and the HR function in the UK voluntary sector

Cunningham

2016

The International Journal of Human Resource Management

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“…Research on disabled people largely focused on adults with learning disabilities and largely ignored physically impaired individuals, despite some noteworthy exceptions such as the IBSEN study in England. Furthermore, there have been concerns that direct payments would deskill and fragment those providing services as service users hired their own care assistants and tended to favour the cheapest and least qualified, preventing the development of a skilled and well-paid workforce (Fotaki, 2011;Leece, 2010;Manthorpe, Moriarty, et al, 2011;Scourfield, 2005;Spandler, 2004). More generally, Spandler and Vick (2006) suggest that direct payments could serve as an excuse for simple cost cutting.…”

Section: Direct Payments For Disabled Peoplementioning

confidence: 99%

The risk of users’ choice: exploring the case of direct payments in German social care

Junne

Huber

2014

Health, Risk & Society

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In this article, we explore the risks associated with direct payments to users enabling them to purchase social care. These payments are intended to enable people with disabilities to make choices and increase their autonomy. However, there is little evidence in the existing literature about the risks involved in direct payments as seen by service users. In this paper, we draw on data from a qualitative study of direct payments for people with disabilities in a federal state of Germany. We interviewed 37 individuals involved in direct payment schemes including individuals receiving payments, care assistants, members of organisations providing care and the administrative officers of the local authorities between December 2011 and January 2014. In this article, we use a governmentality perspective to explore how individuals who received the payments saw and sought to manage the risks associated with the scheme. We found that while users reported that direct payments reduced the risk associated with being directly dependent on the care providers and hence increased their desired selfdetermination, they identified new risks linked to their liability for the transferred money, problems associated with their liquidity and cash flow, challenges presented by budget cuts, and sanctions resulting from violation of norms of 'appropriate use' and the difficulties of negotiating with the funders. To manage these perceived risks users indicated that they had subjected themselves to a new way of active self-control and self-management, normalising their behaviour. We note that risk to service users has been neglected in policy design and should be acknowledged more explicitly. IntroductionIn this article, we examine users' accounts of the choices and risks they face and what effects direct payments and user choice have on them. Drawing on governmentalityinspired research, we conceptualise the reactions of users as a form of active selfsubjectivation -a way of governing through freedom (Rose, 1999). To do this, we draw on data from a case study of user choice around direct payments to people with special needs, ranging from serious physical to mental impairments, in Germany. We show how, contrary to a discourse emphasising choice and freedom, risks shape part of the lifeworld of recipients of user choice. Contributing to governmentality-inspired research on risk, we explore how users in social care subject themselves through selfcontrol and self-management in this context and how risks serve as a springboard for this.

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“…In the English context the direct employment of PAs has been seen to represent a wholesale transfer of power from the state to the individual (Leece 2010), fitting into Christensen's conception of the master/servant relationship. Shakespeare (2006, 139) characterised the personal assistance model as being based on an assumption that 'care could be disaggregated into practical tasks … and emotional content, which was rejected'.…”

Section: The Value Of the Personalmentioning

confidence: 99%

Cash payments in context: (self-)regulation in the new social relations of assistance

Graham

2015

Disability & Society

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Cash payments to meet social care needs offer the possibility for the direct employment of personal assistants using public funds. Empirical work internationally has identified the benefits of cash payments. However, there has been less interest in the relationships between employers and their employees. This article offers some reflections upon the employment relationship from the perspectives of employers who have learning difficulties and their personal assistants. The study involved eight employers, their supporters and their personal assistants in an English city. A grounded theory approach was utilised and interviews were analysed using a framework approach. This article argues that the relational aspects of direct employment arrangements have not been adequately considered in academic literature and the policy framework. These insights can add to debates around how social care support mechanisms can offer responsive assistance whilst questioning the assumed 'empowering' effect of an unregulated market.

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Paying the Piper and Calling the Tune: Power and the Direct Payment Relationship

Cited by 35 publications

References 10 publications

Personalisation, austerity and the HR function in the UK voluntary sector

Personalisation, austerity and the HR function in the UK voluntary sector

The risk of users’ choice: exploring the case of direct payments in German social care

Cash payments in context: (self-)regulation in the new social relations of assistance

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