What are Direct Payments?
Direct Payments is money paid by the local authority
directly to a person whom it has assessed as needing community
care services. The local authority makes the payment instead of
arranging services, allowing people to purchase services to meet
their own community care needs.
Under existing legislation local authorities
are able to make Direct Payments to disabled people with community
care needs, people over 65, 16 and 17 year olds, and disabled
parents to assist them in their parenting role.
The Community Care and Health (Scotland) Act
2002
In 2003 provisions in the Community Care and
Health (Scotland) Act introduce changes to the existing system
of Direct Payments.
- Local authorities will have a duty to offer direct payments
to people eligible and willing to receive them who require community
care services by 1 June 2003
- Direct Payments will become available to all community care
client groups on 1 April 2004
- Recipients of direct payments will be able to purchase care
services from local authorities on 1 June 2003. Currently local
authorities are not allowed to sell their services to Direct
Payments recipients.
- A representative will be able to consent to, set up, vary
and receive Direct Payments on behalf of a person who is unable
to give consent him/herself. This will mean that attorneys and
guardians with the relevant powers will be able to make the
necessary arrangements to ensure that a person can receive Direct
Payments. This provision is aimed to increase uptake amongst
people with mental health problems or learning difficulties.
Parents will also be allowed to consent to Direct Payments to
purchase the services their children are assessed as needing.
This provision will be commenced on 1 June 2003.
- Direct Payments will still require a personal contribution
from some recipients however the new legislation will make clear
that payments can be made on a "gross" basis and the user's
contribution recovered later. The Act gives authorities a mechanism
to recover the amount it has assessed a person as being able
to contribute – from 1 June 2003.
Impact of the changes
All persons will now be eligible for Direct Payments
except those specified by regulations. This widens the scope of
the Direct Payments scheme to all community care client groups
including people who are frail, require rehabilitation treatment
following accidents or operations, are fleeing domestic abuse
or recovering from drug or alcohol addiction.
Local authorities will have a duty rather than
a power to offer Direct Payments as an alternative to arranging
services only if that person gives his or her consent to the arrangement.
Currently if a local authority believes that
a person is unable to consent to direct payment arrangements it
cannot offer the services. The new system allows for a person
to consent to direct payment arrangements on behalf of a person
whom the local authority is satisfied is unable to give consent.
Direct Payments Scotland
Direct Payments Scotland has been established
with funding from the Scottish Executive to increase the uptake
of direct payments in Scotland.
Its core aims are:
- Increase awareness of direct payments amongst community care
users, local authority staff and service providers
- Establish and develop user-led support organisations
- Establish a national information service and provide good
practice exchange
- Identify and address training needs for support staff and
local authority staff.
Issues for UNISON
Whilst recognising the need to empower people
to make their own community care decisions, UNISON Scotland has
a range of concerns relating to:
- How local authorities respond to the new Direct Payments system.
- The organisation and delivery of the new system.
- The impact on UNISON members working in care services in the
public, private, voluntary and independent sectors.
Our concerns include:
- Are local authorities and their staff geared up to respond
to the changes to Direct Payments, in administering, service
provision, and meeting the needs of clients purchasing community
care from local authorities?
- The ability of recipients to successfully arrange services
to meet their needs. An evaluation pilot scheme in Glasgow Social
Work concluded that recipients had difficulty in finding a personal
care assistant suitable to their needs.
- Will recipients opt to keep some or all of the cash instead
of purchasing services? The Glasgow pilot also indicated that
recipients needed greater support in managing and utilising
Direct Payments.
- Direct Payments do not allow recipients to offer decent rates
of pay to personal assistants. There are also a number of employment
rights issues on the impact of recipients as "employers" of
personal assistants providing care to them.
- Will public services be adversely affected by recipients choosing
alternative provision?
- How will the services provided under Direct Payments be regulated?
- Is Direct Payments being more widely promoted as a way of
cutting costs?
- How will this impact on members providing care services in
the voluntary and independent sectors?
Action for Branches
- Check what provisions your local authority / private / voluntary
sector employer has in place in preparation for Direct Payments.
- Ensure that appropriate training and awareness for staff in
social work and community care services is taking place.
- Ensure that Direct Payment recipients are receiving support
and assistance to enable them to make appropriate choices, and
that they get support where they are acting as employers to
personal assistants.
- Raise UNISON's concerns on Direct Payments with local authority
employers, with local councillors, MSPs and MPs.
Further Information:
Direct Payments Scotland:
www.dpscotland.org.uk
Scottish Executive:
www.scotland.gov.uk
Contacts list:
Dave Watson - d.watson@unison.co.uk
@ The P&I Team
14 West Campbell St
Glasgow G26RX
Tel 0845 355 0845
Fax 0141-307 2572
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