Introduction

We should not be surprised if the issue of personalisation and personal budgets has come to be seen as controversial and contentious. What perhaps would be more concerning would be if it were treated as straightforward and without complexity. Indeed, that has been one of the significant features of political approaches to personalisation. It has gained support from all three main political parties and tended to be treated as unproblematic. However, as soon as we consider the context of this idea and development, it becomes possible to see some of the serious traps lying in wait for it, and also to begin to explore ways of overcoming them.

First, a point about my position on this issue. Historically, there has been some polarisation of discussion, with some people and constituencies strongly for or strongly against personalisation and personal budgets. This has at times been a fraught and disturbing situation, with some commentators who have been critical of this development marginalised and excluded (Boxall et al, 2009). My background as a long-term health and social care service user has put me in a different position. Over the years since the 1970s, a number of different developments have taken place in social care (extending in some cases to health). These include the establishment of social services departments, the introduction of community social work and then community care, care management, the ‘purchaser–provider split’ and now ‘personalisation’. Each of these innovations has been heralded as offering more cost-effective and responsive services and systems of support. In some cases, the rhetoric of increased choice and control that has come to be associated with personalisation has also been emphasised – notably in the case of community care. The evidence has indicated that each of these developments, some of which like community social work have been effectively short-lived, has failed to bring the gains promised for them. It is not necessarily clear whether this is because of limitations of their own, or because of the chronic underfunding and other problems that have affected social care and the particular way in which they were implemented. When adult service users are asked about their experience of social care, they tend to present an overall picture of provision that is inadequate in scale and quality, with diminishing access and availability.