Buying Independence : Using Direct Payments to Integrate Health and Social Services

How can direct payments help disabled and older people to break down the "Berlin Wall" between health and social care?

This volume shows how disabled people do not make clear distinctions between "health" and "social care".

Through direct payments, they are able to control and integrate into their daily routines a wide range of health-related activities, such as physiotherapy and nursing tasks, in ways which offer increased independence and better quality of life, compared with conventional health services.

Yet assistance with healthcare rarely features in assessments for direct payments; nor is it reflected in the rates of pay disabled people are able to offer their personal assistants.

As direct payments are extended to older people and disabled children, is this yet another subtle shift in the boundary between "health" and "social" services? And if so, what are the implications for direct payments users and the personal assistants they employ?Drawing on the perspectives of disabled people, personal assistants and health professionals and managers, this is an exploration of how direct payments can improve further the integration of services, and enhance users' control over an ever wider range of regular daily routines.