1.9 The landscape of personalisation in Scotland
We now turn to development of personalisation in Scotland. Scotland is and has been exposed to many of the same influences as the rest of the UK: the changes brought about by the 1990 NHS and Community Care Act , the tensions around ‘expert’ professional knowledge, and the increasing voice and role of service user movements. At the same time there are important legal, social and cultural differences between Scotland and some other parts of the UK which are perhaps most evident in relation to its social welfare policy.
Since the re-establishment of the Scottish Parliament in Edinburgh in 1999, Scotland has had ‘devolved powers’ for policy in health, social care, education and other aspects of social welfare. There are different views about the extent of Scotland’s policy divergence from the rest of the UK, and particularly England, since devolution, and it is important to acknowledge the impact of UK parliament and global economic influences on Scotland as part of the UK. However there is evidence that Scotland’s political decision-making tends to be more ‘consensual and negotiated’ than in England, influenced by generally more liberal and collectivist social values and public support for a ‘social democratic welfare state attitudes’ (Keating, 2005, p. 1). This emphasis has had an impact on the way that ideas about personalisation have developed north and south of the border and why, for example, a consumerist, market-driven model of health and social care has taken less of a hold in Scotland than in England.
The growing importance of personalisation in social services in Scotland was emphasised in Changing Lives : The 21st Century Social Work Review in Scotland , which identified ‘building the capacity for personalised services’ as one of its key outcomes. The report said:
Increasing personalisation of services is both an unavoidable and desirable direction of travel for social work services. Unavoidable in the sense that the population and policy expects it; desirable in the extent to which it builds upon the capacity of individuals and communities to find their own solutions and to self-care, rather than creating dependence on services.
A report by the think tank, Demos, identified two key drivers for personalisation in Scotland:
- Changing demand: Growing numbers of people increasingly wanting and expecting services that meet their particular needs.
- Changing supply: Professional models of care that are being perceived as too expensive and too inflexible to meet these demands. Individual and community self-help seen as a means of providing affordable, flexible personalised services.
Demos has suggested that professionals' emphasis on risk management, resource allocation, gate keeping and controlling service delivery was getting in the way of personalisation (Leadbetter and Lownsbrough, 2005, p. 4).
Personalisation: A Shared Understanding (Scottish Government, 2009) identified three things that need to happen to ensure that ‘personalisation happens for everyone’:
You will be exploring these different aspects of personalisation as you continue to work through this course.