Individualism versus Collectivism in Care

People Someone holding an elderly woman's hand
ViewsMay 28th, 2012

Wales has a long history of co-operation. It is a history that starts in the 1840s but endures to this day in credit unions, John Lewis and the Co-operative Group.

While it may be a part of the history of Wales, we believe that it can also be a part of the future delivery of social care in Wales, enabling care users to contribute to their communities as well as get the services they require.

Social care is changing in Wales. Far more is delivered by independent providers, through contracts with local authorities, than used to be the case and personalised services (limited to direct payments in Wales) mean around 3,000 disabled people in Wales are able to choose their own provider or hire their own staff.

As with many disability charities, personalisation, which is where disabled people have greater control over the services provided to them, is a vision we endorse. We want to see disabled people having greater control and independence in care.

But personalisation presents new challenges.

Direct payments – a key way personalisation has been introduced – can leave individuals feeling isolated. There is a difference between accessing care in the community, and being part of that community. Too much emphasis on providing individual care risks leading to the side-lining of other benefits that care can provide, such as friendships, relationships and support networks.

Another concern is that the market has failed to create real choice for those in receipt of direct payments. Even in England, where there are a far greater number of people in receipt of personal budgets or direct payments, there is yet to be a flourishing care market created to respond to personalisation. Just giving individuals money is not enough to create a diverse market.

Scope Cymru has published a new way of thinking about this debate.  Our report, ‘Individualism vs Collectivism in Care: can direct payments help build stronger communities?’ shows how co-operation in social care can provide a way for disabled people to improve their care outcomes and contribute to community life.

By combining their direct payments, disabled people can regain power over the market and use their greater economic influence to contribute to their own communities.

Pooling their purchasing power can help to stimulate markets, creating the diversity in services that is needed. Co-operatives could work with local providers to get the services that their members want and larger co-operatives would even be able to put their services out to tender to encourage new providers into an area.

The benefits of co-operative structures are not just aligned to purchasing power, but also the support that a co-operative would be able to provide to its members.

This support could be in the form of assistance with managing direct payments or it could be in the form of social support through meeting other co-operative members. This would help to reduce isolation and develop inclusion with the local community through providing better outcomes through mutual support..

You can find a copy of our report at:

This is an approach that can be a Welsh solution to the challenges of social care. The Welsh Government can help to support the development of new co-operatives by developing a pilot project to in order to start developing the ideas that are contained within our work into practical solutions that can start to deliver the benefits of this approach directly to disabled people.

This pilot should include a growth fund to support these developments as well as an independent evaluation to ensure the models that are developed achieve the outcomes for the individuals and communities involved.

By looking at these solutions, the Welsh Government can ensure that those in receipt of direct payments have the power to drive the market to meet their needs.

Matt O’Grady is Senior Policy and Campaigns Officer (Wales) at Scope Cymru 

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