Trials of personal budgets, where people receive direct payments to allow them to arrange and buy their own support services instead of getting them from their local council, have raised concerns about the effect on older people.

The aim of personal budgets is to give individuals the power to decide the nature of their own support. The budgets bring together resources from different funding streams into a single sum that can be spent flexibly in accordance with needs and preferences. The money can be paid to recipients directly for them to make their own arrangements, or they can ask the Council to provide services. They can also have a mixture of both methods.

There was a mixed response from users in the trials. Older people did not find the individual budget system as easy to use as the other groups, and they did not appear to like the idea of managing their own support. In contrast, mental health service users reported a significantly higher quality of life. Younger physically disabled people received a higher quality of care and were more satisfied with the help they received. People with learning disabilities felt that they had control over their daily lives.

Organisations involved with older people have sounded warnings about personal budgets. Gordon Lishman, Director General of Age Concern, said: “Giving people money to buy their own care doesn’t suit everyone, and as this research shows, some people will need more support than others if they are to see this as a benefit not a burden. Even with the right support in place, having an individual budget must be a choice, not the only option. Nor should people be pressurised into having one because it is cheaper for the local authority.

Martin Green, Chief Executive of English Community Care Association said: “There is a need to ensure equity for all client groups and individual budgets, which are essentially about choice, control and autonomy. They must be made real for everyone, not just certain groups. The transformation agenda must be about every service user, whether they live in residential services or their own home. Choice, control and autonomy are about how people experience services, not where they live”.