Public expenditure on services for people with intellectual disabilities

The allocation of resources to health and social care agencies for services for people with intellectual disabilities has led to considerable debate about the failure of the balance of financing to reflect recent changes in policy. Although the overwhelming need of people with intellectual disabilities is for social care in the community there is still concern that funds are tied to health or institutional services. This paper presents the results of a two-year project to explore these and related issues by developing national estimates of expenditure on services for people with intellectual disabilities through information gathered from a stratified sample of local authority areas. At local levels, information was requested from social services, health authorities, district housing authorities and local education authorities. The information from health and social services authorities was extrapolated to national levels to allow comparison with the most recent national programme budget figures. The information from housing and education authorities was to inform debates over substitution, where health and social services substitute the activities of other local authority departments for their own. The results confirm that at local levels the majority of expenditure remains under health auspices. The national estimates generally represented an increase over the Department of Health's programme budget figures, though this was anticipated given the different service coverage. The paper concludes with a discussion of the implications of the results both for local agencies and central government.