M. Foster, Catherine Needham, Eloise Hummell, S. J. Borg, K. Fisher
{"title":"导论:个性化与协作:老年人和残疾人个性化资助政策的双重紧张关系","authors":"M. Foster, Catherine Needham, Eloise Hummell, S. J. Borg, K. Fisher","doi":"10.1017/S147474642200046X","DOIUrl":null,"url":null,"abstract":"Individualisation and marketisation in policy areas such as disability, health and social care, mental health and aged care has increasingly replaced the ‘one-size-fits all’ welfare model in many western economies. For older and disabled people, this has come about through the adoption of individualised funding models that acknowledge the right to autonomy and self-determination (Earle and Boucher, 2020) and promote personalisation of supports (Dickinson and Glasby, 2010; Mladenov et al., 2015; Pearson et al., 2018; Prandini and Orlandini, 2018). Importantly, this shift is simultaneously seen as a force for personalisation by disaggregating block-funded or contracted services, and for collaboration through promotion of co-operative or networked arrangements in provision of supports (Claes et al., 2010). Although not necessarily oppositional, personalisation and collaboration can however be in tension within an increasingly marketised sector that thrives on competition and differentiation (Green et al., 2018). This themed section situates and critically examines this interplay of personalisation and collaboration, discussing comparative examples and street-level research, with a focus on older and disabled people. The aim is to shed light on the various theoretical drivers of personalisation and collaboration, alongside the complexities and interdependences of support for older and disabled people, and how these dual forces might be managed in practice. Individualisation for older and disabled people operates through many forms. For example, direct payments, personal budgets, self-directed support, and consumer-directed care, which are typical in the UK and Ireland (Ferguson, 2012; Fleming et al., 2016; Pearson et al., 2018), and in Australia, individual budgets, which may or may not be selfmanaged (Laragy et al., 2015). Likewise, there are variable drivers and ideologies, which have influenced the evolution and uptake of these new forms, and the extent to which diverse interests have coalesced (Pearson et al., 2018). As an example, despite the appeal of direct payments driven by grassroots reform, local authorities in Scotland were initially sceptical about the privatisation agenda (Pearson et al., 2018), as was the case in Australia where concerns ensued about marketisation overshadowing rights-based reform (Fawcett and Plath, 2014). Nevertheless, in seeking to personalise services and supports for people with complex needs all such models are highly reliant on good collaboration in the organisation of services and implementation of supports (Claes et al., 2010; Needham and Dickinson, 2018; Fleming et al., 2019). Yet, reliance on good collaboration is also risky. A marketised, and more competitive environment, heightens the issue of financial Social Policy & Society (2023) 22:1, 122–126 © The Author(s), 2022. 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For older and disabled people, this has come about through the adoption of individualised funding models that acknowledge the right to autonomy and self-determination (Earle and Boucher, 2020) and promote personalisation of supports (Dickinson and Glasby, 2010; Mladenov et al., 2015; Pearson et al., 2018; Prandini and Orlandini, 2018). Importantly, this shift is simultaneously seen as a force for personalisation by disaggregating block-funded or contracted services, and for collaboration through promotion of co-operative or networked arrangements in provision of supports (Claes et al., 2010). Although not necessarily oppositional, personalisation and collaboration can however be in tension within an increasingly marketised sector that thrives on competition and differentiation (Green et al., 2018). This themed section situates and critically examines this interplay of personalisation and collaboration, discussing comparative examples and street-level research, with a focus on older and disabled people. The aim is to shed light on the various theoretical drivers of personalisation and collaboration, alongside the complexities and interdependences of support for older and disabled people, and how these dual forces might be managed in practice. Individualisation for older and disabled people operates through many forms. For example, direct payments, personal budgets, self-directed support, and consumer-directed care, which are typical in the UK and Ireland (Ferguson, 2012; Fleming et al., 2016; Pearson et al., 2018), and in Australia, individual budgets, which may or may not be selfmanaged (Laragy et al., 2015). Likewise, there are variable drivers and ideologies, which have influenced the evolution and uptake of these new forms, and the extent to which diverse interests have coalesced (Pearson et al., 2018). As an example, despite the appeal of direct payments driven by grassroots reform, local authorities in Scotland were initially sceptical about the privatisation agenda (Pearson et al., 2018), as was the case in Australia where concerns ensued about marketisation overshadowing rights-based reform (Fawcett and Plath, 2014). Nevertheless, in seeking to personalise services and supports for people with complex needs all such models are highly reliant on good collaboration in the organisation of services and implementation of supports (Claes et al., 2010; Needham and Dickinson, 2018; Fleming et al., 2019). Yet, reliance on good collaboration is also risky. 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引用次数: 0
Introduction: Personalisation and Collaboration: Dual Tensions in Individualised Funding Policy for Older and Disabled Persons
Individualisation and marketisation in policy areas such as disability, health and social care, mental health and aged care has increasingly replaced the ‘one-size-fits all’ welfare model in many western economies. For older and disabled people, this has come about through the adoption of individualised funding models that acknowledge the right to autonomy and self-determination (Earle and Boucher, 2020) and promote personalisation of supports (Dickinson and Glasby, 2010; Mladenov et al., 2015; Pearson et al., 2018; Prandini and Orlandini, 2018). Importantly, this shift is simultaneously seen as a force for personalisation by disaggregating block-funded or contracted services, and for collaboration through promotion of co-operative or networked arrangements in provision of supports (Claes et al., 2010). Although not necessarily oppositional, personalisation and collaboration can however be in tension within an increasingly marketised sector that thrives on competition and differentiation (Green et al., 2018). This themed section situates and critically examines this interplay of personalisation and collaboration, discussing comparative examples and street-level research, with a focus on older and disabled people. The aim is to shed light on the various theoretical drivers of personalisation and collaboration, alongside the complexities and interdependences of support for older and disabled people, and how these dual forces might be managed in practice. Individualisation for older and disabled people operates through many forms. For example, direct payments, personal budgets, self-directed support, and consumer-directed care, which are typical in the UK and Ireland (Ferguson, 2012; Fleming et al., 2016; Pearson et al., 2018), and in Australia, individual budgets, which may or may not be selfmanaged (Laragy et al., 2015). Likewise, there are variable drivers and ideologies, which have influenced the evolution and uptake of these new forms, and the extent to which diverse interests have coalesced (Pearson et al., 2018). As an example, despite the appeal of direct payments driven by grassroots reform, local authorities in Scotland were initially sceptical about the privatisation agenda (Pearson et al., 2018), as was the case in Australia where concerns ensued about marketisation overshadowing rights-based reform (Fawcett and Plath, 2014). Nevertheless, in seeking to personalise services and supports for people with complex needs all such models are highly reliant on good collaboration in the organisation of services and implementation of supports (Claes et al., 2010; Needham and Dickinson, 2018; Fleming et al., 2019). Yet, reliance on good collaboration is also risky. A marketised, and more competitive environment, heightens the issue of financial Social Policy & Society (2023) 22:1, 122–126 © The Author(s), 2022. Published by Cambridge University Press. doi:10.1017/S147474642200046X