Self-directed care and individual budgets: transforming provider-centred service systems to person-centred systems in community care
Vern Hughes
National Federation of Parents, Families and Carers
Contact Email:   verncivilsociety.org.au

The paper examines the issues and challenges in transforming provider-centred service systems in disability, aged care, chronic and mental illness to person-centred systems characterised by self-directed care and individual budgets.

The paper identifies six key structural components in this transformation:

1. Aggregation of resources from disparate programs into person-centred individual budgets.

2. Introduction of a ‘per person unit cost’ for all programs and services, so that individuals and their agents may purchase a suite of units of service and support to fit their personalised needs.

3. Establishment of a budget holding and management facility, independent of service providers.

4. Establishment of a retail market in community care, independent of service providers, in which comparative price and quality information about services and service providers is available to individuals.

5. Establishment of a technology-based platform to enable individuals and their agents to manage self-directed care and individual budgets.

6. Consolidation of provider-held information into a person-centred information system to include all components of an individual’s history and care plans.

The paper explores recent policy and practice innovation in the UK and various Australian states towards self-directed care and self-managed individual budgets, and examines issues arising from this innovation. The paper concludes with an assessment of the strategic and political obstacles to person-centred reform of human service systems in Australia.

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