Debates about personalisation in certain ways take us back to the closure of long stay institutions, community-based living and disabled people wanting to live life in the mainstream. More recent shifts to direct payments and personal budgets, although more precise delineations of choices and rights, would not have been possible were it not for these earlier antecedents. Each in their way stemmed from disabled people's and families’ disillusion with paternalist social ‘care’ policy (Borsay, Reference Borsay2004). The above edited collection, from a range of influential writers, is an important attempt to draw on a specific interpretation of the latter development – that of personalisation. I mention the above history because, as Beresford makes clear in the book, the language of personalisation was derived from policy and interest groups not linked to the above struggles by disabled and survivor groups themselves. However, and by way of fairness to all parties, social support is sought by and provided to a population well beyond those who would self-define as disabled and who may be far removed from disabled people's organisations (Watson, Reference Watson2002). Indeed the theme of diversity, the need to comprehend the very diverse needs and rights of those that seek social care and support seems key to an evaluation of the book itself.
This edited work is far-reaching and includes those with diametrically opposed views of personalisation. It provides service user, academic, policy and practice voices. The book is very well framed and written. Part one provides a clear contextualiusing of the book's scope and aims. Parts two and three provide critical insights on personalisation policy and take in challenges of Resource Allocation (RAS), the limited comprehension of personalised safeguarding and limitations to take up of personal budgets (PBs). Part three explores street-level experiences, achievements and frustrations which help bring the question of the value of personalisation to life. There are clearly people who like and benefit from PBs. Part four, perhaps the least engaging aspect of the book, explores the question of personal health budgets (PHBs). The recent and inchoate nature of PHBs and the tendency to ignore the major differences between social and health care make this feel something of a gear change and a distraction. I can see why it is included, but I could not really see what was being purchased with PHBs and just what PHBs are in practice. This was not the case in the extensive discussion of PBs in social support. Part five is an engaging summary of the book's key messages.
A key strength of the book is its sense of being a fair-minded guide to debates without a sense of proselytising. The polarity of views probably necessitates this. However, the editors are meticulous in navigating the choppy waters that frame personalisation debates. I liked the choice of chapter themes and the inclusion of chapters drawing on good sources of evidence. I also liked the reflection in a number of chapters as to just what good evidence on personalisation is. There was mention of research design and rigour which was unexpected and very helpful. I also liked the very incisive appraisal of policy, law and practice at the heart of many of these chapters. As I mentioned above, diversity needs accounting for in such analyses, and the book is exemplary on this point. Professional, service user, carer and wider family standpoints are provided. Service user diversity: age, place, impairment, social networks, care economies were all covered and no one voice allowed to dominate. There is only one key omission I feel, that of the need to unpack the term personalisation further. The possible links to neo-liberal individualisation are mentioned; however, the term personalisation merits further critical examination from a sociological perspective – so personalisation as, sa,y a fundamental challenge to machine bureaucracy; as a post-Fordist trope (Mitchell in Stubbs and Geoffrey, Reference Mitchell, Stubbs and Underhill2012) to a wholesale personalisation of risk (see Roulstone in Beresford, Reference Beresford2014). However, these are implicit in the wider book. By the end of this very comprehensive offering, one is left with the sense that parties may be talking past each other inadvertently. That is not to diminish in any way the very passionately held views evident in the book. However, most agree that the voice of the service user is central; after all, without that detail the term personalisation would be meaningless. The tailoring of support options, including direct cash transfers, brokerage, third party arrangements, while allocating fairly and openly, all seem important and irreducible. The critics of personalisation though have every right to be suspicious of personalisation in linguistic and policy use. The setting of targets for PB take up is clearly absurd in the context of real choice (Slasberg et al., Reference Slasberg, Beresford and Schofield2012). The decision to call a mix of direct payment and direct service a personal budget is equally the cause of major suspicion that smoke is being deployed alongside mirrors. The fear that direct payments may externalise risk to users is clearly true in some ways – as the example of early tribunal cases in employment disputes makes clear. However, risk and the taking of risk are not inimical to choice and are arguably central to widening the social horizons of ‘service users’. We should however be critical as social scientists of any further attempts to use the language of choice, independence and personhood in a way that obscures what might be bad policy, loss of choice and the impact of austerity (Glasby, Reference Glasby2014). This is a very important and timely addition to the social care/support canon and I would recommend the book unreservedly to both policy and practice audiences alike.
