Books published by The Centre for Welfare Reform

The King's Fund's report Reforming the NHS from Within questions the wisdom of decades of structural reform within the NHS. The report's author, Professor Chris Ham, argues that a confused cocktail of markets, regulations and targets has detracted from more positive possibilities. He offers a more human account of the kinds of changes that would help strengthen the NHS.But does the King's Fund's critique go far enough?David Zigmond argues that there are even graver issues to consider. The National Health Service, at its best is about supporting and sustaining thoughtful, caring and knowledgeable relationships between professionals and citizens. But too many managerial initiatives undermine agency and harm relationships. Treating staff like robots, or patients like items on a conveyor belt, is dehumanising and dangerous. Much more attention needs to be given to the factors that strengthen our relationships: Doing things at a human scale - not progressively more giant Working with trust and flexibility - not meaningless regulations Providing security and freedom - not financial penalties and incentivesZigmond's work explores the limits of industrialised healthcare and calls for fresh thinking about how to restore and protect the human dimension of the NHS.

Extract from the Foreword: The use of an Individual Service Fund as a way that people can have more control, choice and flexibility in their support is not a new idea. In Scotland, Individual Service Funds have been used by a small number of organisations for more than 20 years as a way to enable people to take more control over their life and their support, even if they were not deemed to have the capacity to take a Direct Payment. The authors of this paper have a long standing commitment to this approach and can describe clearly how an Individual Service Fund works and why it makes Self-Directed Support available for everyone.This paper was commissioned by In Control Scotland with the aim of promoting inclusion and social justice through greater understanding of the benefits of the creative use of Individual Service Funds It is intended to be an enabling document which will be of value to individuals, families, care providers and funders It is intended to inspire greater consideration of the untapped transformational potential of Individual Service Funds by providing lived examples It also takes the form of a provocation, intended to stimulate questions and conversations about where power, choice and control lie in any situation involving an individual budget.