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A comparative analysis of personalisation: balancing an ethic of care with user empowerment
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Ethics and Social Welfare, 5(2), June 2011, pp.138-152.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
Modern developments in care and support delivery for disabled and older people have led to the expansion of personalisation schemes, where money is paid in substitute for care and support. Although the schemes have been evaluated within their own national contexts, little work has been done so far to explore the theoretical implications of their development and extension, particularly from an ethics of care perspective. This paper fills that gap by drawing on comparative evidence from several schemes across different nations to develop an analysis which draws on feminist theory and an ethics of care approach to examine: the gendered policy outcomes and impact of such schemes; a feminist analysis of the governance implications of personalisation; the implications for the gendered division of work, particularly between paid and unpaid care work and between different groups of paid and unpaid carers; an ethics of care analysis of the impact of personalisation over the lifecourse of disabled and older people, and carers; and a discussion of the relationship between commodification, empowerment, citizenship and choice drawing on the work of care ethicists.
A comparative discussion of the gendered implications of cash-for-care schemes: markets, independence and social citizenship in crisis?
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Social Policy and Administration, 43(6), December 2009, pp.634-648.
- Publisher:
- Wiley
In the context of moves across many countries away from state-led provision of services for disabled people towards cash-based systems, and concerns on the part of feminist scholars about the implications of commodifying care for women, this article undertakes a comparative literature review and policy analysis of the role of policy development and outcomes in cash-for-care schemes, looking at policy developments in several countries. It examines the impact of tensions between various governance levels, particularly local and national government, the gendered impact of such policies on gendered divisions of paid and unpaid work, citizenship and social participation, the impact such policies have or may have on different groups of men and women and different social and economic groups, and how such policies can contribute to the well-being and/or detriment of different groups. The author concludes that cash-for-care schemes and the objective of cost containment leads to risks for users and leaves carers employed by such schemes vulnerable to exploitation, that there are nevertheless some potential gains in terms of gender equity deriving mainly from the introduction of choice and control which can have a significant impact on well-being, that allowing carers to choose whether to engage in paid or unpaid care can free them from disempowering obligations, and that even gender-neutral or gender-blind policies can have significant gendered outcomes.
Healthy partnerships, healthy citizens? An international review of partnerships in health and social care and patient/user outcomes
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Social Science and Medicine, 69(12), December 2009, pp.1797 -1804.
- Publisher:
- Elsevier
In developed welfare states, changes in the governance of health and social care organisations have resulted in increasing pressure for them to work with each other and with the voluntary and private sectors. Through reviewing literature found by searching the major social science and medical databases, the author examines the policy drivers behind these changes and looks at the effects the changes have had on health and social care delivery, in particular to the three most vulnerable groups – older people, mental health service users and children. Some evidence suggests that patient/user outcomes may in some cases be unaffected but that in others increased partnership working in health and social care can compromise more vulnerable service users. In conclusion the author suggests that more evidence regarding partnership work needs to be collected, that the literature review should be expanded to cover a wider range of non-English language and grey literature and that more work be done on ranking the methodologies adopted by the 76 studies examined.
Disabled citizens and social exclusion: the role of direct payments
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Policy and Politics, 34(4), October 2006, pp.633-650.
- Publisher:
- Policy Press
This article develops a framework of citizenship, in the light of current developments in social theory, policy and practice, to analyse the social rights and duties of disabled citizens in the UK. It looks at the complex interplay between disabled people's roles as carers, cared-for, workers and employers, by moving the debate on from seeing disabled people as the passive recipients of care to seeing them as active citizens. It asks whether developments in policy, such as the growing use of direct payments, can support disabled people in their struggle to avoid social exclusion and be treated as full citizens.
Partnership and collaborative governance in welfare: the citizenship challenge
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Social Policy and Society, 5(2), April 2006, pp.293-303.
- Publisher:
- Cambridge University Press
Whilst there is ample literature on the governance and management of partnerships in welfare, particularly within mixed-economy states, much of it has focused on the governance and organisational capacity issues. This paper draws on that body of literature and evidence from health and social care partnerships, and attempts to develop the theoretical and empirical work in the area to address the issue of citizens' social rights, asking whether collaborative governance and partnerships between agencies are the solution to promoting citizens' social participation, or another state-driven method of indirectly enhancing social exclusion.
Progress towards partnership? The development of relations between primary care organisations and social services concerning older people's services in the UK
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Social Policy and Society, 3(1), January 2004, pp.33-42.
- Publisher:
- Cambridge University Press
Presents evidence from the interim results of a large scale three-year longitudinal project designed to track the development of partnership working between the new primary care organisations (Primary Care Groups and Trusts) entrusted with the commissioning and in some cases provision of health care, and local authority social services departments, regarding health and social care services for older people in the UK. Drawing on theoretical work concerning the role of partnership working in the governance of welfare, the author uses a framework originally devised by the Nuffield Centre for Health at the University of Leeds to analyse the interim data, and to draw conclusions about the feasibility of current policy pushes towards partnership working and service integration around health and social care for older people.
Disability, citizenship and community care: a case for welfare rights?
- Author:
- RUMMERY Kirstein
- Publisher:
- Ashgate
- Publication year:
- 2001
- Pagination:
- 201p.,bibliog.
- Place of publication:
- Aldershot
This book develops the theory of social citizenship in a way that is relevant to current analyses of the future of the welfare state. It examines the role community care policy and practice plays in shaping disabled people's citizenship in the UK, providing compelling evidence of the ways in which the welfare state can either support, or act as a barrier to disabled people's social participation. The author lays out a challenge to the current relationship between disabled people and the welfare state.
The way forward for joint working? Involving primary care in the commissioning of social care services
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Journal of Interprofessional Care, 13(3), August 1999, pp.207-218.
- Publisher:
- Taylor and Francis
This article explores the different ways in which GPs and the primary health care team are involved in working together with social services in the planning, commissioning and purchasing of social care services for individuals or groups of patients in the UK.
Changes in primary health care policy: the implications for joint commissioning with social services
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Health and Social Care in the Community, 6(6), November 1998, pp.429-437.
- Publisher:
- Wiley
Both the primary health care team (PHCT) and social services departments in the UK have undergone substantial changes to their organisation and function since 1990. The article looks at developments in primary health care policy that have affected the relationships between them regarding the commissioning of health and social care services. It focuses on evidence from seven initiatives designed to involve members of the PHCT in commissioning social care services. It examines some of the benefits and challenges of working together to commission services for health authority managers, GPs, district nurses, care managers and social work team managers in the light of impending changes to the PHCT, particularly the abolition of fundholding and the introduction of Primary Care Groups.
Accessing assessment: the perspective of practitioners, disabled people and carers
- Author:
- RUMMERY Kirstein
- Journal article citation:
- Social Services Research, 2, 1997, pp.11-21.
- Publisher:
- Social Services Research Group
Reports on the results of research which explored how social work practitioners were using the new forms of assessment procedures introduced by local authorities; and obtained the views of disabled people and carers on what they thought of these new arrangements for assessment. The study aimed to increase understanding of the barriers faced by disabled people in accessing support and assistance to live full and independent lives; to explore how carers viewed assessment; and to identify the ways in which disabled people and carers could play an active part in assessment arrangements. Discusses the implications for practice.