Programme budgeting revisited: special reference to people with learning disabilities

The recent reorganisation of community care removed many of the perverse incentives identified in the previous system. However, the organisation of care for many people is still divided across several agencies in the public and independent sectors. As purchasing and providing agencies in both the NHS and local authority personal social services attempt to coordinate policy objectives and the means to achieve them, the total resources available and their allocation across different care groups and amongst people in the same care groups form a consistent focus of attention. The principles and practice of programme budgeting provide important lessons for planning and monitoring expenditure. This paper rehearses such principles in the specialised area of policies for people with learning disabilities and draws on the experience of mapping expenditure on relevant services in a survey over ten local authorities in England.