The role of government in the implementation of personal budget policies : access, organization and choice

Policies for people with disabilities have undergone a significant change internationally. In a short period of time, the idea of 'personalisation of care' became the dominant narrative in many modern welfare states worldwide. In essence, policymakers aim to transform care and support policies for people with disabilities from a supply-driven to a demand-driven practice. Personal budget policies are one of the most tangible forms of personalization in practice. Instead of subsidizing care providers, the government allocates resources in the form of a personal budget to the individual with support needs. With this budget the individual can make his own choices about how, where and by whom he is supported. This policy should lead to more efficient, flexible and less paternalistic care. This dissertation studies the impact of this paradigm shift in care for people with disabilities with a specific focus on the implementation, and on what the implications are for the role of government. Particular attention is paid to the three important tasks that the government assumes in this context: (1) providing access to care and support, (2) organizing a market of care and (3) providing opportunities for persons with disabilities and their networks to make choices in practice.