Based on an article by Karen Christensen and Doria Pilling from Journal of Social Policy

Independence has become one of the Western world’s central ideas. In the long-term care sector in Norway and England this idea is translated into the policies termed personalisation. These policies aim at giving older and disabled people more choice and control; and central to this aim is the welfare scheme which is internationally known as the cash-for-care scheme. This welfare scheme is used in both Norway and England to allocate funding to users so that they can employ – with or without help from various organisations – their own care workers. These workers are called ‘personal assistants’ to emphasise the difference from traditional care work for dependent rather than independent people.

This article provides a classic comparative policy analysis of cash-for-care arrangements in Norway and England. It points out the impact of political context when implementing policies of personalisation in these two countries. Taking a theoretical point of departure in the difference between a liberal British welfare state and a social democratic Norwegian one, two different discourses about ‘public’ policies are stressed: a market discourse stressing a consumer role for welfare users, and a democratic discourse stressing a citizen role. The two discourses are contrasting choice/control with rights.

The article’s concrete analysis then, however, shows how the discourses are ‘crossing’ when the ideas are implemented, resulting in a ‘consumer right’ and a ‘citizen choice’. While the right to cash-for-care in England is strong, the access through needs and means testing (with only needs testing in Norway) is very restricted and is contributing to leaving out real choices, although this was the main aim. In Norway the right is profoundly weak, but the options of choosing and controlling in terms of managing an independent life are potentially stronger. In England choice and control involves considerable and complex individual responsibility, a requirement for a variety of support organisations, or being a customer and having the difficulty of navigating through a large care provider market

Generally, the authors Christensen and Pilling thus conclude that the impact of political context is crucial to the ways of implementing policies of personalisation. They furthermore suggest that if policies of personalisation really aim at supporting people in shaping independent lives, the route through the state rather than the market, stressing citizen roles rather than consumers’ roles, is worth taking into consideration in the development of future long-term care policies.

Read the entire article without charge here until 31st July 2014

 

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