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Choice: What, when and why? Exploring the importance of choice to disabled people

Parvaneh Rabiee, Social Policy Research Unit, University of York


Extending choice and control for disabled and older people over public services is central to current policies in England. Government proposals published in 2005 include significant increases in the choices that users of social care and other services are able to exercise over the support they receive. Despite some powerful criticisms of welfare consumerism, and concerns about the challenges of making choices by some groups of disabled and older people, research suggests that choice is fundamental to achieving independence, social inclusion and principles of citizenship and human rights.

However, choice may have distinctive significance for disabled young people, adults and older people; people with on-going, complex, multiple or changing needs for support. It is therefore important to know more about what choices are important, for which groups of people and in what areas of life. Without this knowledge and understanding such policies may not live up to their immense potential to achieve welfare gains.

The paper presents findings from the first phase of a longitudinal qualitative study that explores the realities of exercising choice about support and other related services in the context of changing circumstances. Semi structured interviews were carried out with 100 participants including disabled young people with progressive conditions and their parents; adults and older people with fluctuating support needs and those who have experienced a sudden deterioration in health.

The findings suggest that while there are some similarities between the different groups of study members in the areas in which choices are important, there are also significant differences in the priorities and importance that people attach to specific choices about different issues. The findings have implications for traditional social care and other service arrangements, and identify policy and practice issues that need to be addressed.

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