Exploring Consumer Directed Care

Talk by Dr Simon Duffy for the Multicultural Communities Council of South Australia, 1 December 2014 in Adelaide

Exploring Consumer Directed Care

Dr Simon Duffy

I’ve worked at developing systems of self-directed support for 25 years, working as a service provider and working with (and against) government. My training is in philosophy and my practice has involved an on-going effort to think about why we do what we do.

After working on individualised funding in early 1990s I developed Inclusion Glasgow - an innovative service provider in 1996. IN 2003 I led In Control and developed the model of self-directed support which was (to some extent) adopted by the English government.

In 2009 I set up The Centre for Welfare Reform as hub for social international social innovation and a platform for challenging injustice. I am currently involved in various campaigning efforts in the UK to combat the way ’austerity’ is targeting people with disabilities and people in poverty.

• UK experience of self-directed support

• Lessons that should be relevant to CDC

• Citizenship and rights not services

• Exploring our roles in a changing world

Sami Helle at European Parliament, November 2013

“We are obliged to surrender to the will of the strong. Big companies, cities and municipalities decide what is best for us. This is about power. Why do I feel a lack of power in my own life?”

English data 2003-2005, first In Control pilot

English data 2005-2007

1. Not markets - community

• There is no evidence that the benefits of self-directed support are about markets - except for the fact that the basic right to take your budget elsewhere might help ‘wake people up’

• It’s not markets - it’s citizens, community and creativity that make the difference in people’s lives

2. Not plans - control• People do not change their lives by planning to change

their lives. But planning (and training to plan, or training to train to plan) becomes one of the biggest ways the system wastes people’s time and money.

• People learn to change their lives by having control and using that control to make positive changes, plus

• By learning from other people who’ve made positive changes or people who can share real expertise

• Change is simple and social - keep it that way

The government money fallacy

it can’t always be government money:

where did government get it from?

3. Not them - us

• There is no evidence that the benefits of self-directed support relies on complex systems of independent advocacy or service brokerage.

• Sometimes a fresh face and pair of hands can help, but mostly its about giving the people who are already there the chance to do something better.

4. Not government - people

• Government and bureaucracies don’t innovate - citizens and leaders innovate.

• Creating systems that both enable innovation at the individual level and encourage innovation in processes and communities will be critical.

5. Not consultants - peers• Government funded enthusiasm tends to

manufacture phoney expertise - we seek comfort in going to consultants - the fatter the better - to hold our hands.

• But real expertise comes from people with lived experience of the innovation.

• Champions of innovation need to create their own peer support.

Self-directed support demands a new way of managing - NOT the middle

Remember the true purpose

We make citizenship real by1. Finding our sense of purpose

2. Having the freedom to pursue it

3. Having enough money to be free

4. Having a home where we belong

5. Getting help from other people

6. Making life in community

7. Finding love

This protects our dignity1. Our life is seen to have meaning

2. We are not on someone else’s control

3. We can pay our way - we’re not unduly dependent

4. We have a stake in the community

5. We give others the chance to give

6. We contribute to the community

7. We are building the relationships that sustain community

“My life, my rights”1. Independent living

2. Entitlement

3. Self-determination

4. Clarity

5. Flexibility

6. Learning

7. Contribution

What will could this all mean for you or your organisation?