Charging at the point of delivery

This is a guest blog by Phil Jew, head of Policy & Campaigns at AdviceUK and Head of Policy at Action for Advocacy.

Phil_Jew_50pxThe increasingly difficult task of sustaining services that are free at the point of delivery (POD) is forcing some in the voluntary and community sector (VCS), to consider the scope for introducing fees. The two network bodies I work for (AdviceUK and Action for Advocacy) have both held debates about charging at annual conferences this year.

Provoking strong reactions

The idea of asking service users to pay for services provokes strong and sometimes extreme reactions from those in the VCS. There are those who would quit today if their organisation levied a charge. Others see an opportunity to make their services sustainable.

Of course, the post second world war settlement of free universal access to key services is long dead. There is a means test now for most public services and there has been for many years. Indeed, in the advice world, eligibility for Legal Aid has been based on means since the establishment of the scheme in 1949. Eligibility has been successively reduced and the current Government is proposing further cuts. Contributions to costs are also collected by the Legal Services Commission. So some not for profit advice services, although late-comers to the delivery of legal aid services, are no strangers to means testing and fees (albeit not collected directly by them).

The world of personal budgets has been inhabited by advocacy services and advice services for several years now. The prospect of funding for advocacy and advice coming from personal budgets for health, social care and other needs rather than paid in advance contracts or grants is a real one. Then we could all be collecting fees, from richer and poorer clients.

Fighting to retain access to free services

What all people working in VCS advice and advocacy services can agree on is that we must fight to retain access to free at the POD services for those who simply can’t afford to contribute to the cost. Free independent advice and independent advocacy services respectively are essential to ensure that people who may be in poverty, disadvantaged, vulnerable or at risk can uphold their rights and wishes. But to enable a free at the POD service, somebody must support it financially – central or local government, trusts and foundations, voluntary effort, other earned income and donations. Maybe, many are beginning to argue and practice, free at POD services can and should be cross-subsidised and sustained by charging those who can and even should pay.

The debate about charging is essential

The reality is that in such cash-strapped times, recovering the full costs of free at the POD services is increasingly difficult. 74 per cent of non statutory advocates who responded to Action for Advocacy’s Advocacy in a Cold Climate survey this year stated that funding is insufficient to cover their work. So the debate about charging as a possible means of sustaining services is essential.

The gainsayers believe that the introduction of charges at the POD for welfare/rights advice or health and social care advocacy would fundamentally change the nature of the service and the relationship with the client. Both advice and advocacy services have roots in community self-help. They emerged because people in the community were failing to gain access to rights and not having their views and wishes taken into account. However professional such services may have become, they still grapple with the same injustice. To introduce the barrier of a fee would deny access and perpetuate inequalities. Simply having the financial ability to pay does not imply capability to decide to pay. Organisations could end up chasing people at risk who have not paid their bill. The relationship between adviser or advocate and client would change. Fee payers may have different expectations of the service – for example around availability and results. Two tier services could emerge. Trust – the bedrock of both independent advice and advocacy services – could break down.

The costs of charging

Even if these ethical issues can be overcome, many doubt that charging really provides a key to sustainability. Few of the people who have traditionally accessed advice and advocacy services can afford to pay for them. They certainly can’t afford the price that would generate sufficient profit for re-investment in free services.

Fee charging services have new costs associated with them anyway, which would eat into profit margins. New regulatory requirements may apply – for example VCS advice agencies employing solicitors cannot charge for services without a waiver from the SRA. A new trading arm may well be needed. Marketing would be needed to attract fee payers. Assessment of means would be required, fees would need to be collected and new bureaucracy would result. Trustees would need to be willing to take a risk on up-front investment. Existing funders – local authorities, PCTs, Health Trusts etc may see an opportunity to reduce their funding if fees generate alternative income.

Exploring the options

So charging is far from an easy fix. But there are those who are finding ways to make it work. Advice services are looking at fees for assistance with DLA applications, home visits, advice for landlords and certain types of immigration advice. And those at both Action for Advocacy and AdviceUK conferences this year voted to continue to explore the options and at least not to castigate those who do.

The alternative maybe a continued contraction of free at POD services offered by the VCS; with the private sector moving in to fill the gap. Many in the advice and advocacy sectors are appalled by the service offered by some unregulated private fee-charging companies for advice and advocacy (The Office of Fair Trading closed down 62 Debt Management firms this year after finding incompetent advice and misleading charging policies). It is better that we do it well and offer a good quality, ethical and relatively low-cost service. The VCS often prides itself on its holistic, person centred approach. We certainly need to get better at putting a realistic price on services we think are of great value – even if we don’t change all ‘customers’ for them at the POD.

Phil Jew

Find out more

AdviceUK has a ‘charging for advice?’ discussion paper and comments on its web site.

For more comment on advice and advocacy issues see the AdviceUK’s Transforming Advice, Transforming Lives blog.

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