Starting in April 2008, millions of pensioners will be handed control over how the money is spent, rather than relying on social workers to make the decisions. As reported in the BBC News On-Line, Health Secretary Alan Johnson, who officially announced the scheme on Monday, said it was a “radical transfer of power from the state to the public”.

Individuals will be means-tested to assess their health and personal needs, and councils will then pay the cash into their bank accounts or those of nominated relatives.

According to the government, the changes are designed to create more competition among care agencies.
Similar programs exist in other European countries. A 2005
OECD study
showed that other countries, such as The Netherlands and the USA have developed a variety of cash benefit programs to allow dependent persons and their families more individual choice among care options. Consumer choice can improve the self-determination and satisfaction of older persons and increase the degree of independent living, even in cases of dependency. Surveys have shown that greater choice and consumer direction can contribute to better quality of life at a similar cost compared with traditional services.

In the UK, Campaign Group Age Concern did welcome the scheme.
Director General Gordon Lishman said: “It is absolutely right to put older people’s needs at the centre of the care system and to place a clear emphasis on preventive services.
“Older people and their families will continue to need information and support to help them negotiate the best care package at the best price with care providers.
“This will be challenging but we are sure it is something the government will want to address.”